Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Jina K Martin

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1043917511

MS. Jina K Martin is a Nurse Practitioner in Providence, Rhode Island. Qualified in 2024, 2 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
2
Licensed in
RI
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

164 Summit Ave
Providence, RI 02906-2853
Phone: (401) 793-4102
Fax: (401) 793-4049
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence APRN04553 (RI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (RI)

Record details

NPI number1043917511
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 14, 2023
Last updated in NPPESApril 29, 2025
Certification dateApril 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Lifespan Physician Group Inc — 1125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Providence