Organization Active NPI

James B Martin MD LLC

  • Health Service Clinic/Center
  • Ocean Springs, MS
National Provider Identifier
1205083110
Registry record updated Aug 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
MS5001 Issued in MS
Legal business name
JAMES B MARTIN MD LLC
Practice address
1103 Hanley Rd
Ocean Springs, MS 39564-3108
Phone
(228) 875-3097
Fax
(228) 875-3299
NPI assigned
Aug 21, 2008
Last updated
Aug 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2008

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

Authorized official

Name
Dr. James Burke Martin, MDNPI 1427113000
Title
Doctor/Owner
Phone
(228) 875-3097

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X MS5001 MS Primary

Addresses

Primary practice location

1103 Hanley Rd
Ocean Springs, MS 39564-3108

Mailing address

1103 Hanley Rd
Ocean Springs, MS 39564-3108
Phone (228) 875-3097

Other identifiers 1

IdentifierTypeStateIssuer
00017758MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080911000413 MS Part B Supplier - Clinic/Group Practice 2163598392 Receives reassigned benefits from 2 practitioners
Practice locations: Ocean Springs, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2080554James B Martin MD LLC1103 Hanley Road, Ocean Springs, MS 39564Certificate of waiverJun 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
James B Martin MD LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1219276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219276800000",
    "number": "1205083110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 HANLEY RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643108",
            "telephone_number": "228-875-3097",
            "fax_number": "228-875-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 HANLEY RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643108",
            "telephone_number": "228-875-3097",
            "fax_number": "228-875-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES B MARTIN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-21",
        "last_updated": "2008-08-21",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "BURKE",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "228-875-3097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MS",
            "license": "MS5001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00017758",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2008; 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.