Individual provider Active NPI

Jeanne M Martin, MD

  • Pediatrics Physician
  • Athens, GA
National Provider Identifier
1063543080
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
060405 Issued in GA
Practice address
1500 Oglethorpe Ave
Ste. 2500
Athens, GA 30606
Phone
(706) 548-7909
Fax
(706) 548-7973
NPI assigned
Mar 8, 2007
Last updated
Jun 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 060405 GA
Pediatrics Physician 208000000X 060405 GA Primary

Addresses

Primary practice location

1500 Oglethorpe Ave
Ste. 2500
Athens, GA 30606

Mailing address

2727 Paces Ferry Road
Suite 1-1100 (Attention Denise)
Atlanta, GA 30339
Phone (470) 271-3421

Other identifiers 1

IdentifierTypeStateIssuer
494634830AMedicaidGA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081229000350 GA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 3779645718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Athens Primary Care LLCGroup PAC ID 0648520841, 80 clinicians

Practice addresses (Care Compare)

1500 Oglethorpe Ave
Suite 2500
Athens, GA 30606-2189
Phone (706) 548-7909

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Athens Primary Care LLC CurrentSince Jul 1, 2018 Accepting new patients

Locations

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

1500 Oglethorpe Ave
Ste 2500
Athens, GA 30606
Phone (706) 543-0471

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1063543080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 PACES FERRY ROAD",
            "address_2": "SUITE 1-1100 (ATTENTION DENISE)",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30339",
            "telephone_number": "470-271-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE",
            "address_2": "STE. 2500",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606",
            "telephone_number": "706-548-7909",
            "fax_number": "706-548-7973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JEANNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "060405",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "060405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "494634830A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.