Garry M Martin

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

523025 Issued in WI

Practice address

503 S Chestnut Ave
Marshfield, WI 54449-3605

Phone

(715) 384-3323

Fax

(715) 389-2532

NPI assigned

Sep 21, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1184610685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 S CHESTNUT AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544493605",
            "telephone_number": "715-384-3323",
            "fax_number": "715-389-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 S CHESTNUT AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544493605",
            "telephone_number": "715-384-3323",
            "fax_number": "715-389-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "GARRY",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "WI",
            "license": "523025",
            "primary": true
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "WI",
            "license": "523025",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WI",
            "license": "523025",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43204300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marshfield Clinic, Inc. (Marshfield Clinic Specialty Pharmacy)
• Marshfield Podiatry Services
• Marshfield Senior Services, Inc
• Marshfield Senior Services,, LLC
• Martin Dental SC
• Gary Paul Martin, DDS
• Kelsea Martin, PA
• Nora Melissa Martin, PA-C
• Teresa Martin, PTA
• Lucy C Martinek, M.D.

• Primary Podiatric Medicine Podiatrist in Marshfield, WI
• Providers in Marshfield, WI by specialty
• Primary Podiatric Medicine Podiatrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.