Beverly Lynn Martin, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR001404 Issued in GA

Practice address

5604 Wendy Bagwell Pkwy Ste 311
Hiram, GA 30141-7814

Phone

(770) 222-5881

Fax

(770) 222-5883

NPI assigned

Feb 6, 2007

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

Enrolled in GA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1979

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Easy Walk Foot Clinic LLC

  • Foot & Ankle Surgery Podiatrist
  • Fayetteville, GA
  • NPI 1508155037
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1114066032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 WENDY BAGWELL PKWY STE 311",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301417814",
            "telephone_number": "770-222-5881",
            "fax_number": "770-222-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 WENDY BAGWELL PKWY STE 311",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301417814",
            "telephone_number": "770-222-5881",
            "fax_number": "770-222-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BEVERLY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR001404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIREMENT MEDIC",
            "identifier": "P00244592",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlan Mansour
• Marietta Eye Clinic, PA
• Marietta Eye Optical Inc
• Mark Lynn O.D. & Associates, P.C.
• Daniel Marti, DC
• Catherine Martin, M.D.
• Derek Deshan Mason, DDS
• Katherine F Mault, AU.D.
• Miranda Elyse McClure
• Michele McColligan, LPC

• Chiropractor in Hiram, GA
• Providers in Hiram, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.