Individual provider Active NPI

Sharalyn Marrion Martin, NP-C

  • Nurse Practitioner
  • Ellenwood, GA
National Provider Identifier
1023437381
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN 133278 Issued in GA
Practice address
209 Saint Lukes Way
Ellenwood, GA 30294-2978
Phone
(678) 520-1616
NPI assigned
Apr 15, 2014
Last updated
Apr 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN 133278 GA Primary

Addresses

Primary practice location

209 Saint Lukes Way
Ellenwood, GA 30294-2978

Mailing address

209 Saint Lukes Way
Ellenwood, GA 30294-2978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250502002742 GA Practitioner - Nurse Practitioner 7416271952 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN 133278GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Smart Care Clinic & Wellness Spa LLC CurrentSince Apr 10, 2025 Accepting new patients

Locations

2254 Highway 42 N
McDonough, GA 30253
Phone (678) 753-7800

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1023437381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 SAINT LUKES WAY",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 SAINT LUKES WAY",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942978",
            "telephone_number": "678-520-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHARALYN",
        "middle_name": "MARRION",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN 133278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

Verify at the official NPI Registry.