Individual provider Active NPI

Jonathan Martin, M.D.

  • Psychiatry Physician
  • Corbin, KY
National Provider Identifier
1174908230
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
52464 Issued in KY
Practice address
1 Trillium Way
Corbin, KY 40701-8727
Phone
(606) 523-8521
Fax
(606) 523-8742
NPI assigned
Jul 29, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X R3842 KY
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 52464 KY Primary

Addresses

Primary practice location

1 Trillium Way
Corbin, KY 40701-8727

Mailing address

5200 Commerce Crossings Dr
Louisville, KY 40229-2182
Phone (502) 253-4966

Other identifiers 1

IdentifierTypeStateIssuer
7100429370MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmartin96743@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20190523002056 KY Practitioner - Psychiatry 1355621996 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, shared by 31 NPIs, 2,431 clinicians

Practice addresses (Care Compare)

96 Future Dr
Corbin, KY 40701-8988
Phone (606) 528-0305

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Jun 25, 2019 Accepting new patients
Baptist Health Medical Group Inc Psychiatry CurrentSince Jun 25, 2019 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jul 8, 2019 Accepting new patients
Baptist Healthcare System, Inc Past Accepting new patients

Locations

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

96 Future Dr
Corbin, KY 40701

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

5200 Commerce Crossings Dr
Louisville, KY 40229
Phone (502) 253-4900

2700 Stanley Gault Pkwy
Ste 129
Louisville, KY 40223
Phone (502) 253-4900

Organizations & group practices 4

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 1

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": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1174908230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 COMMERCE CROSSINGS DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402292182",
            "telephone_number": "502-253-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TRILLIUM WAY",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018727",
            "telephone_number": "606-523-8521",
            "fax_number": "606-523-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-29",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "R3842",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "52464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100429370",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmartin96743@bhkydirect.com",
            "affiliation": "N",
            "address_1": "1 Trillium Way",
            "city": "Corbin",
            "state": "KY",
            "country_code": "US",
            "postal_code": "407018727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.