Jerry Vann Martin, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

A23873 Issued in CA

Practice address

2500 Mowry Ave
Suite 212
Fremont, CA 94538-1605

Phone

(510) 608-6174

Fax

(510) 745-6435

NPI assigned

Jul 22, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Washington Township Hospital Development Corporation

  • Urgent Care Clinic/Center
  • Fremont, CA
  • NPI 1427089754
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1013172733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7079 HOMEWOOD DR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946111451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MOWRY AVE",
            "address_2": "SUITE 212",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381605",
            "telephone_number": "510-608-6174",
            "fax_number": "510-745-6435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JERRY",
        "middle_name": "VANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "A23873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Marshall
• Colleen Anne Martin Chicoine, WHNP/CNM
• Yesica Martin Pablo
• Dianne C Martin, MD
• Erica L Martin, LVN
• Kemari Sanaa Krystal Martin
• Magaly Martin
• Taliva Donley Martin, M.D.
• Tiffany Monique Martin
• Vanessa Rae Martinez Guerra

• Emergency Medical Services (Emergency Medicine) Physician in Fremont, CA
• Providers in Fremont, CA by specialty
• Emergency Medical Services (Emergency Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.