Active NPI
John R Martell Jr., M.D.
- Orthopaedic Surgery Physician
- Augusta, GA
National Provider Identifier
1205829249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- L3007
- Practice address
- 1120 15TH St
Augusta, GA 30912-0004 - Phone
- (706) 721-4666
- NPI assigned
- Aug 24, 2005
- Last updated
- Aug 29, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | L3007 | TX | Primary |
| Orthopaedic Surgery Physician | 207X00000X | 051062 | GA |
Addresses
Primary practice location
1120 15TH St
Augusta, GA 30912-0004
Mailing address
1499 Walton Way
Suite 1400
Augusta, GA 30901-2602
Phone (706) 724-6100
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000934557F | Medicaid | GA | |
| 000934557D | Medicaid | GA | |
| G51062 | Medicaid | SC | |
| 000934557E | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19189 | AL | MD | Pharmacist |
| 051062 | GA | MD | Orthopaedic Surgery Physician |
| L3007 | TX | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John R Martell Jr MD PA | Orthopaedic Surgery | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Orthopaedic Surgery Physician
- Cleburne, TX
- NPI 1821270448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219968000000",
"number": "1205829249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1499 WALTON WAY",
"address_2": "SUITE 1400",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309012602",
"telephone_number": "706-724-6100",
"fax_number": "706-722-5187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120004",
"telephone_number": "706-721-4666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTELL",
"first_name": "JOHN",
"middle_name": "R",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2008-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "TX",
"license": "L3007",
"primary": true
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "GA",
"license": "051062",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000934557F",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000934557D",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G51062",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000934557E",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.