Individual provider Active NPI

Stephanie Martin, FNP-C

  • Nurse Practitioner
  • Macon, GA
National Provider Identifier
1215429881
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN204463 Issued in GA
Practice address
540 Hemlock St
Macon, GA 31201-3202
Phone
(478) 743-8953
Fax
(478) 743-1963
NPI assigned
May 30, 2018
Last updated
Jun 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN204463 GA Primary

Addresses

Primary practice location

540 Hemlock St
Macon, GA 31201-3202

Mailing address

540 Hemlock St
Macon, GA 31201-3202
Phone (478) 743-8953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180830003714 GA Practitioner - Nurse Practitioner 9739439324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The ENT Center of Central Georgia, PCGroup PAC ID 6103817556, 18 clinicians

Practice addresses (Care Compare)

540 Hemlock St
Macon, GA 31201-3202
Phone (912) 743-8953

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
57.28 of 100Reported as group
Quality
60.36
Promoting interoperability
0
Improvement activities
40
Cost
80.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN204463GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The ENT Center of Central Georgia, P.C. CurrentSince Jun 3, 2024 Accepting new patients
Magnolia ENT, LLC PastSince Jun 1, 2024 Accepting new patients

Locations

540 Hemlock St
Macon, GA 31201
Phone (478) 743-8953

6084 Lakeview Rd
Ste 100
Warner Robins, GA 31088
Phone (478) 743-8953

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: s.martin@direct.theentcenter.nextgenshare.com

Organizations & group practices 2

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.

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": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1215429881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013202",
            "telephone_number": "478-743-8953",
            "fax_number": "478-743-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013202",
            "telephone_number": "478-743-8953",
            "fax_number": "478-743-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "STEPHANIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-30",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN204463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.