Organization Active NPI

Keith C. Martin MD PC

  • Obstetrics & Gynecology Physician
  • Montgomery, AL
National Provider Identifier
1013690601
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
KEITH C. MARTIN MD PC
Practice address
7065 Sydney Curv
Montgomery, AL 36117-3509
Phone
(334) 647-1007
Fax
(334) 647-1117
NPI assigned
Aug 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Authorized official

Name
Keith C Martin, MDNPI 1356358808
Title
Physician Owner
Phone
(334) 398-1636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

7065 Sydney Curv
Montgomery, AL 36117-3509

Mailing address

69 Ava LN
Wetumpka, AL 36093-3457
Phone (334) 647-1007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230914002475 AL Part B Supplier - Clinic/Group Practice 1052775608 Receives reassigned benefits from 1 practitioner
Practice locations: Montgomery, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1013690601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 AVA LN",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360933457",
            "telephone_number": "334-647-1007",
            "fax_number": "334-647-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7065 SYDNEY CURV",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173509",
            "telephone_number": "334-647-1007",
            "fax_number": "334-647-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH C. MARTIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "334-398-1636",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.