Individual provider Active NPI

Martha Wolfram St John, MD

  • Psychiatry Physician
  • Houston, TX
National Provider Identifier
1073534921
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
L9500 Issued in TX
Practice address
14811 Saint Marys LN Ste 270
Houston, TX 77079-2908
Phone
(281) 497-3500
Fax
(281) 497-3512
NPI assigned
Jul 23, 2006
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X L9500 TX Primary

Addresses

Primary practice location

14811 Saint Marys LN Ste 270
Houston, TX 77079-2908

Mailing address

14811 Saint Marys LN Ste 270
Houston, TX 77079-2908
Phone (281) 497-3500

Other names 1

  • Martha Irene Wolfram Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070220000177 TX Practitioner - Psychiatry 3173625340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical School at Houston, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Martha St. John, M.D., P.a.Group PAC ID 6002918273, 2 clinicians

Practice addresses (Care Compare)

14811 Saint Marys LN
Suite 270
Houston, TX 77079-2908
Phone (281) 497-3500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martha St. John, M.D., P.a. Psychiatry CurrentSince Oct 1, 2006 Accepting new patients

Locations

11757 Katy Fwy
Ste 380
Houston, TX 77079
Phone (281) 497-3500

14811 Saint Marys Ln
Ste 270
Houston, TX 77079
Phone (281) 497-3500

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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1073534921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14811 SAINT MARYS LN STE 270",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770792908",
            "telephone_number": "281-497-3500",
            "fax_number": "281-497-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14811 SAINT MARYS LN STE 270",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770792908",
            "telephone_number": "281-497-3500",
            "fax_number": "281-497-3512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST JOHN",
        "first_name": "MARTHA",
        "middle_name": "WOLFRAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "L9500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "WOLFRAM",
            "middle_name": "IRENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.