Jason A. Martin
Individual provider Active NPI Family Nurse Practitioner · Decherd, TN
NPI 1083173488 · NPPES record last updated Jan 29, 2025
Key facts
- NPI
- 1083173488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 25475 (TN)
- Practice address
- 2006 Decherd Blvd
Decherd, TN 37324-3818 - Phone
- (931) 967-7171
- NPI assigned
- Mar 15, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Amg-Southern Tennessee LLC
Practice addresses (Care Compare)
2006 Decherd Blvd
Decherd, TN 37324-3818
Phone (931) 967-0931
Hospital & facility affiliations
- Southern Tennessee Regional Health System Winchest
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190429001818 | TN | Practitioner - Nurse Practitioner | 2769724434 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25475 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Amg-Southern Tennessee LLC | Current |
Accepting new patients | |
| Amg-Southern Tennessee LLC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Amg -Southern Tennessee LLC | Past | Accepting new patients |
Locations
330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780
2006 Decherd Blvd
Decherd, TN 37324
Phone (931) 962-0561
491 Majors Blvd
Lynchburg, TN 37352
Phone (931) 759-4727
600 N Jackson St
Tullahoma, TN 37388
Phone (931) 563-5469
83 Memorial Dr
Winchester, TN 37398
Phone (931) 967-3966
Interoperability endpoints
- jason.martin.1@19363.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 25475 | TN | Yes |
Addresses
Primary practice location
2006 Decherd Blvd
Decherd, TN 37324-3818
Mailing address
PO Box 1258
Waynesboro, TN 38485-1258
Phone (931) 253-1110
Other providers in Decherd, TN
- Leah Jayne Kowalewski
- Kroger Limited Partnership I
- William Andrew Kuhar Jr.
- Constance June Lynch
- Main St Medical Supply LLC
- James Thomas McClure
- Jacob McNeil
- Northland Hearing Center, Inc.
- Leonard Hugh Parton
- Wendy Mon-Gen Pierce Patton
All providers in Decherd, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.