Individual provider Active NPI

Aldwin Terrell Martin, DC

  • Chiropractor
  • Sterling, VA
National Provider Identifier
1154669307
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO010067 Issued in GA
Practice address
46169 Westlake Dr Ste 300
Sterling, VA 20165-5875
Phone
(703) 421-2990
Fax
(703) 421-2822
NPI assigned
Jan 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104557046 VA
Chiropractor 111N00000X CHIRO010067 GA Primary

Addresses

Primary practice location

46169 Westlake Dr Ste 300
Sterling, VA 20165-5875

Mailing address

2770 Lenox Rd NE Ste B-2
Atlanta, GA 30324-6006
Phone (678) 973-0503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230221001149 GA Practitioner - Chiropractic 4486025921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2770 Lenox Rd NE
Suite B2
Atlanta, GA 30324-6006
Phone (678) 973-0503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIRO010067GAMDChiropractor
0104557046VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Palmercare Chiropractic Atlanta LLC Chiropractor CurrentSince Jun 13, 2018 Accepting new patients

Locations

2770 Lenox Rd NE
Ste B2
Atlanta, GA 30324
Phone (202) 489-8551

Organizations & group practices 1

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": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1154669307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 LENOX RD NE STE B-2",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303246006",
            "telephone_number": "678-973-0503",
            "fax_number": "703-421-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46169 WESTLAKE DR STE 300",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201655875",
            "telephone_number": "703-421-2990",
            "fax_number": "703-421-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ALDWIN",
        "middle_name": "TERRELL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-23",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557046",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO010067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.