Active NPI
Martyn Dean Woleben, M.D.
- Obstetrics & Gynecology Physician
- Elizabethtown, NC
National Provider Identifier
1124125422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 97-00428
- Practice address
- 300 E McKay St.
Ste F
Elizabethtown, NC 28337 - Phone
- (910) 862-6672
- Fax
- (910) 862-6674
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 97-00428 | NC | Primary |
Addresses
Primary practice location
300 E McKay St.
Ste F
Elizabethtown, NC 28337
Mailing address
2337 E Broad St
Elizabethtown, NC 28337-8933
Phone (910) 862-1992
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891039C | Medicaid | NC |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 97-00428 | NC | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Main Street Women'S Health, PA | Past | Accepting new patients | |
| Bladen Healthcare LLC | Past | Accepting new patients |
Interoperability endpoints
- mwoleben@crhn.cernerdirect.com
Organizations & group practices 2
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.
-
- Critical Access Hospital
- Elizabethtown, NC
- NPI 1558537282
-
- Specialist
- High Point, NC
- NPI 1467402479
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124125422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2337 E BROAD ST",
"city": "ELIZABETHTOWN",
"state": "NC",
"postal_code": "283378933",
"telephone_number": "910-862-1992",
"fax_number": "910-862-6674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E MCKAY ST.",
"address_2": "STE F",
"city": "ELIZABETHTOWN",
"state": "NC",
"postal_code": "28337",
"telephone_number": "910-862-6672",
"fax_number": "910-862-6674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLEBEN",
"first_name": "MARTYN",
"middle_name": "DEAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NC",
"license": "97-00428",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891039C",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elizabethtown, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.