Individual provider Active NPI

Sydney Martin, DC

  • Chiropractor
  • Bel Air, MD
National Provider Identifier
1093464851
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S04126 Issued in MD
Practice address
2105 Laurel Bush Rd Ste 103
Bel Air, MD 21015-6173
Phone
(443) 512-0025
Fax
(443) 512-8844
NPI assigned
Mar 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S04126 MD Primary

Addresses

Primary practice location

2105 Laurel Bush Rd Ste 103
Bel Air, MD 21015-6173

Mailing address

710 Shallow Ridge CT
Abingdon, MD 21009-3016
Phone (216) 697-8301

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address office@susquespine.com Other Shawn R Lee DC LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1093464851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 SHALLOW RIDGE CT",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210093016",
            "telephone_number": "216-697-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 LAUREL BUSH RD STE 103",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210156173",
            "telephone_number": "443-512-0025",
            "fax_number": "443-512-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SYDNEY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S04126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@susquespine.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Shawn R Lee DC LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "2105 Laurel Bush Rd Ste 103",
            "city": "Bel Air",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210156173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.