KYLE RICHARD MARTIN — NPI 1679344030 (Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) in CANTON, MO)

CMS-1500 Box 24J / 33a • NPI

1679344030

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

207PS0010X (CMS 23)

Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)

Box 32 Service Location & ZIP+4

1 COLLEGE HL, CANTON, MO, 63435-1257

✓ 9-Digit EDI 837 ZIP+4 (63435-1257)

Practice Phone & Referral Fax

(573) 288-6000

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1679344030 (KYLE RICHARD MARTIN) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1679344030` (NPI-1 Individual Practitioner)
Provider / Legal Name	KYLE RICHARD MARTIN
Plain-English Specialty	Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) NUCC Code: `207PS0010X` (Emergency Medicine, Sports Medicine)
Certifying / Licensing Body	American Board of Emergency Medicine (ABEM)
Practice Location Address	1 COLLEGE HL, CANTON, MO, 63435-1257
Practice Telephone / Fax	Tel: (573) 288-6000
Administrative Mailing Address	1 COLLEGE HL, CANTON, MO, 63435-1299
Enumeration & Last Sync	Enumerated: 2024-01-12 \| CMS Record Updated: 2024-01-12

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1 COLLEGE HL, CANTON, MO, 63435-1257

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Plain-English Taxonomy & CMS Crosswalk (207PS0010X)

What Does Taxonomy Code 207PS0010X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207PS0010X translates to:
"Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 23 (Physician/Sports Medicine) • CMS Code 93 (Physician/Emergency Medicine)
Certifying / Accrediting Authority: American Board of Emergency Medicine (ABEM)
Clinical Scope: Immediate life-or-limb emergencies, severe chest pain, stroke symptoms, deep contaminated wounds needing tetanus prophylaxis, or severe dehydration.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KYLE RICHARD MARTIN)

Typical CPT / Diagnostic Procedures:

Level 4 & Level 5 Emergency Department Resuscitation (CPT 99284–99285)
Point-of-Care Emergency Ultrasound (eFAST), Intubation & Central Line Placement
Acute Laceration Repair, Tetanus Prophylaxis & Fracture Splinting

Common Therapeutic Classes:

Epinephrine Auto-Injectors / IV Infusions, Atropine & Amiodarone
Tetanus Toxoid / Tdap & Tetanus Immunoglobulin (TIG)
Empiric Sepsis Antibiotics, Parenteral Ketorolac & Ondansetron

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207PS0010X` — Emergency Medicine, Sports Medicine Plain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)	State: MO \| License: `C054365002` \| Primary: Yes (Primary)

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KYLE RICHARD MARTIN (NPI #1679344030)