Individual provider Active NPI

Chatina Spears Martin, NP

  • Adult Health Nurse Practitioner
  • Byram, MS
National Provider Identifier
1104387695
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
903055 Issued in MS
Practice address
7112 S Siwell Rd Ste C
Byram, MS 39272-8744
Phone
(601) 398-2847
Fax
(601) 510-3883
NPI assigned
Mar 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 903055 MS Primary

Addresses

Primary practice location

7112 S Siwell Rd Ste C
Byram, MS 39272-8744

Mailing address

308 Melba Hill Dr
Jackson, MS 39209-2833
Phone (601) 622-5620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201012002412 MS Practitioner - Nurse Practitioner 1153650304 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

1911 Mission
Vicksburg, MS 39180-3762
Phone (601) 456-2598

7112 S Siwell Rd
Suite C
Byram, MS 39272-8744
Phone (601) 622-5620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
903055MSMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Primary Care Ms CurrentSince Mar 28, 2026 Accepting new patients
Southeastern Transitional Care Management Services CurrentSince Oct 1, 2024 Accepting new patients

Locations

7112 S Siwell Rd
#C
Byram, MS 39272
Phone (601) 398-2847

215 Katherine Dr
#A
Jackson, MS 39232

Interoperability endpoints

  • Direct secure messaging: chatina.martin.p1@direct.magnoliamedical.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1104387695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 MELBA HILL DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392092833",
            "telephone_number": "601-622-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7112 S SIWELL RD STE C",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392728744",
            "telephone_number": "601-398-2847",
            "fax_number": "601-510-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CHATINA",
        "middle_name": "SPEARS",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "903055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Byram, MS

Sources for this page

Verify at the official NPI Registry.