Jeandra S Martin, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT295851 Issued in CA

Practice address

3311 Jessie Village Dr
Clemmons, NC 27012-9963

Phone

(336) 765-7058

Fax

(336) 329-8240

NPI assigned

Dec 19, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, NM2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Transit Physical Therapy PC

  • Physical Therapy Clinic/Center
  • San Bernardino, CA
  • NPI 1417485889

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1215409974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601791",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601791",
            "telephone_number": "336-718-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 JESSIE VILLAGE DR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129963",
            "telephone_number": "336-765-7058",
            "fax_number": "336-329-8240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 N Riverside Ave Ste 240",
            "address_purpose": "LOCATION",
            "city": "Rialto",
            "state": "CA",
            "postal_code": "923768082",
            "country_code": "US",
            "telephone_number": "909-258-2220",
            "fax_number": "909-258-2102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JEANDRA",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT295851",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P25270",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "295851",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marlette Family Practice, PA
• Sarah Marshall, LCSW, LCAS
• William Jeffery Marshall, M.D.
• Axel Martell, RPH
• Aaliyah Martin
• Melissa Lynn Martin
• Seth Andrew Martin, PHARMD
• Lauren Andrea Martinez
• Caralee Amber Mason, RD, LDN
• Mast Drug Co Inc (Mast Long Term Care)

• Physical Therapist in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; 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.