Individual provider Active NPI

Ben R Martin III, MD

  • Gynecology Physician
  • Dothan, AL
National Provider Identifier
1164489498
Registry record updated Mar 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
00008862 Issued in AL
Practice address
4300 West Main Street
Ste 31 Womens Healthcare of Dothan PC
Dothan, AL 36305-4300
Phone
(334) 793-6511
Fax
(334) 677-5642
NPI assigned
Apr 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 00008862 AL Primary

Addresses

Primary practice location

4300 West Main Street
Ste 31 Womens Healthcare of Dothan PC
Dothan, AL 36305-4300

Mailing address

4300 West Main Street
Ste 31
Dothan, AL 36305-4300
Phone (334) 793-6511

Other identifiers 1

IdentifierTypeStateIssuer
000010492MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20100827000619 AL Practitioner - Obstetrics/Gynecology 3274638424 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00008862ALMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Womens Healthcare of Dothan PC CurrentSince Nov 7, 1994 Accepting new patients
Women'S Healthcare of Dothan, PC Current Accepting new patients

Locations

4300 W Main St
Ste 31
Dothan, AL 36305
Phone (334) 793-6511

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.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268265600000",
    "number": "1164489498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 WEST MAIN STREET",
            "address_2": "STE 31",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363054300",
            "telephone_number": "334-793-6511",
            "fax_number": "334-677-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 WEST MAIN STREET",
            "address_2": "STE 31 WOMENS HEALTHCARE OF DOTHAN PC",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363054300",
            "telephone_number": "334-793-6511",
            "fax_number": "334-677-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BEN",
        "middle_name": "R",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2010-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AL",
            "license": "00008862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000010492",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.