Individual provider Active NPI

Vernon George Martzin, RPH

  • Pharmacist
  • Johnson City, TN
National Provider Identifier
1124618699
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9228 Issued in TN
Practice address
300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone
(423) 302-1086
NPI assigned
Jan 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 9228 TN Primary

Addresses

Primary practice location

300 Med Tech Pkwy
Johnson City, TN 37604-2277

Mailing address

252 Hugh Cox Rd
Gray, TN 37615-4141
Phone (423) 747-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vernon.martzin@balladhealth.org Other

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
9228TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1124618699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 HUGH COX RD",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376154141",
            "telephone_number": "423-747-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MED TECH PKWY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042277",
            "telephone_number": "423-302-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTZIN",
        "first_name": "VERNON",
        "middle_name": "GEORGE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "9228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vernon.martzin@balladhealth.org",
            "affiliation": "N",
            "endpointDescription": "Company email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "300 Med Tech Pkwy",
            "city": "Johnson City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376042277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.