Jessie Martin, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ACN783 Issued in FL

Practice address

1415 Colonial Blvd Ste 1
Fort Myers, FL 33907

Phone

(239) 202-4517

NPI assigned

Jul 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Healthwise Medical Practice LLC

  • General Practice Physician
  • Fort Myers, FL
  • NPI 1821573684
  NPD (past) Authorized official

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1073547972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8140 LIRIOPE LOOP",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339727546",
            "telephone_number": "646-267-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 COLONIAL BLVD STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33907",
            "telephone_number": "239-202-4517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 KS HWY 264",
            "address_purpose": "LOCATION",
            "city": "Larned",
            "state": "KS",
            "postal_code": "675509365",
            "country_code": "US",
            "telephone_number": "620-285-4580",
            "fax_number": "620-285-4579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JESSIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERFORMING INDIV. NUMBER",
            "identifier": "105600",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Martin
• David Lee Martin, AP
• Elizabeth Marie Martin, MS
• Ethan Martin, MA, LMHC
• Jeffrey N Martin, D.O.
• Mark Andrew Martin, DO
• Narelle Claire Martin, DO
• Patricia M Martin, CRNA
• Martina Audiology and Hearing Services, LLC
• Mark Martina

• General Practice Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.