Individual provider Active NPI

John Lloyd Martin

  • Family Medicine Physician
  • Hattiesburg, MS
National Provider Identifier
1114489507
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29293 Issued in MS
Practice address
7148 U S Highway 98 Ste 101
Hattiesburg, MS 39402-9133
Phone
(601) 261-1500
Fax
(601) 579-5240
NPI assigned
Apr 3, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 29293 MS Primary

Addresses

Primary practice location

7148 U S Highway 98 Ste 101
Hattiesburg, MS 39402-9133

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7283
Phone (601) 261-1500

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220730000148 MS Practitioner - Family Practice 2567797129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
William Carey University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

Hospital & facility affiliations

  • Enhabit Home Health & Hospice Home health agency, Hattiesburg, MS, CCN 257091
  • Forrest General Home Care Home health agency, Hattiesburg, MS, CCN 257127
  • Mississippi Homecare of Richton Home health agency, Richton, MS, CCN 257120
  • Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078
  • Merit Health Wesley Hospital, Hattiesburg, MS, CCN 250094

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
29293MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic, PA CurrentSince Jul 13, 2022 Accepting new patients
Hattiesburg Clinic PA CurrentSince Jul 13, 2022 Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients

Locations

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

7148 U S Highway 98
Ste 101
Hattiesburg, MS 39402
Phone (601) 226-1150

Interoperability endpoints

  • Direct secure messaging: jmartin44314@directpatientrecord.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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1114489507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017283",
            "telephone_number": "601-261-1500",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7148 U S HIGHWAY 98 STE 101",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394029133",
            "telephone_number": "601-261-1500",
            "fax_number": "601-579-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOHN",
        "middle_name": "LLOYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "29293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.