MARTIN MEDICAL CENTER, P.C. (NPI# 1093768988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093768988 |
| Entity Type | Organization |
| Organization Name | MARTIN MEDICAL CENTER, P.C. |
| Practice Address |
117 Kennedy Dr Martin TN 38237-3309 |
| Practice Telephone | 7315879511 |
| Practice Fax Number | 7315870785 |
| Mailing Telephone | 7315879511 |
| Mailing Fax Number | 7315870785 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2019-10-30 |
| Authorized Official Name | MRS. TAMMY M HAZLEWOOD (ADMINISTRATOR) |
| Authorized Official Telephone | 7315879511 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
TN | Ambulatory Health Care Facilities | |
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BLUE CROSS BLUE SHIELD | 2006779 | 01 |
| TN | 3371015 | 05 |
| Street Address |
117 KENNEDY DR |
| City | MARTIN |
| State | TN |
| Zip Code | 38237-3309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447254164 | Audie B Marlar Jr. | Family Medicine | 117 Kennedy Dr, Martin, TN 38237-3309 | 2005-06-10 |
| 1780060319 | Keely Elizabeth Vaughan | Physician Assistant | 117 Kennedy Dr, Martin, TN 38237-3309 | 2015-08-05 |
| 1558697540 | Leslie Ann Ary | Nurse Practitioner | 117 Kennedy Dr, Martin, TN 38237-3309 | 2009-10-26 |
| 1891908117 | Stefanie Lea Gray | Nurse Practitioner | 117 Kennedy Dr, Martin, TN 38237-3309 | 2007-05-07 |
| 1538135314 | Michael Trent Scates | Physician Assistant | 117 Kennedy Dr, Martin, TN 38237-3309 | 2006-02-23 |
| 1578533048 | Laboratory Corporation of America | Clinical Medical Laboratory | 117 Kennedy Dr, Martin, TN 38237-3309 | 2006-01-25 |
| 1043200280 | Walter Frizzell Fletcher | Emergency Medicine | 117 Kennedy Dr, Martin, TN 38237-3309 | 2005-10-27 |
| 1790784106 | James William Shore | Family Medicine | 117 Kennedy Dr, Martin, TN 38237-3309 | 2005-07-18 |
| 1780683102 | Anna Kristine Hopla | Internal Medicine | 117 Kennedy Dr, Martin, TN 38237-3309 | 2005-07-18 |
| 1871592287 | Susan Shore Lowry | Family Medicine | 117 Kennedy Dr, Martin, TN 38237-3309 | 2005-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578034385 | Megan Ables | Pharmacist | 2253 Mount Pelia Road, Martin, TN 38237 | 2018-12-06 |
| 1336669159 | Alex Reamy | Specialist/Technologist | 15 Mt. Pelia Road, Martin, TN 38237 | 2017-06-22 |
| 1134655731 | West Tennessee Rehabilitation Hospital, LLC | Medicare Defined Swing Bed Unit | 180 Mount Pelia Road, Martin, TN 38237 | 2017-05-03 |
| 1275901381 | William Zimmerman | Chiropractor | 633 Haygood Rd, Martin, TN 38237 | 2015-09-04 |
| 1588080683 | Cory S Davis | Chiropractor | 116 Masonic Dr, Martin, TN 38237 | 2014-03-13 |
| 1063837946 | Tolliver-scott & Associates | Private Vehicle | 113 Kenny Road, Martin, TN 38237 | 2014-02-28 |
| 1982932711 | Anne M Fritcher | Physician Assistant | 189 Mount Pelia Rd, Martin, TN 38237 | 2009-12-07 |
| 1295062669 | Laura C Plunk | Behavioral Analyst | University Commons, Martin, TN 38237 | 2009-11-05 |
| 1710210497 | Stacie M. Callins | Specialist | 180 Mt. Pelia Rd., Healthsouth Cane Creek Rehab. Hospital, Martin, TN 38237 | 2009-09-11 |
| 1275739930 | Diagnostic Imaging Consultants,ltd | Radiology | 215 Hawks Rd Ste 4, Martin, TN 38237 | 2007-06-21 |
| Find all providers in zip 38237 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
| 1124635594 | Bryn Medical Pllc | Clinic/Center | 4295 Cromwell Rd Ste 301, Chattanooga, TN 37421-2163 | 2020-09-29 |
| 1952914285 | Methodist Physician Practice LLC | Clinic/Center | 1211 Union Ave Ste 330, Memphis, TN 38104-6655 | 2020-08-26 |
| 1831721208 | Patientchoicemd, LLC | Clinic/Center | 3274 Wind Shadow Cv, Memphis, TN 38125-0773 | 2020-02-04 |
| 1518515733 | Chs Tennessee Medical P C | Clinic/Center | 800 Howard Baker Ave # Jr, Knoxville, TN 37915-2509 | 2019-08-30 |
| 1245898303 | Summit Medical Group, Pllc | Clinic/Center | 7545 Barnett Way Ste A, Powell, TN 37849-3565 | 2019-06-04 |
| 1992362412 | The Restore Clinic | Clinic/Center | 268 Veterans Pkwy Ste F, Murfreesboro, TN 37128-6432 | 2019-05-20 |
| 1316427602 | Chs Tennessee Medical P C | Clinic/Center | 2680 Pershing Ave, Memphis, TN 38112 | 2018-08-16 |
| 1720565906 | Woodland Medical Pllc | Clinic/Center | 6221 Shallowford Rd Ste 100, Chattanooga, TN 37421-1972 | 2018-07-20 |
| 1861981797 | Chs Tennessee Medical P C | Clinic/Center | 2782 York Rd, Pleasant View, TN 37146-9070 | 2018-05-07 |
| 1316436611 | Lourdes Physician Services LLC | Clinic/Center | 103 Continental Pl Ste 200, Brentwood, TN 37027-1042 | 2018-05-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.