Earl T Martin, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

028602 Issued in GA

Practice address

218 Quarterman St
Waycross, GA 31501

Phone

(912) 287-9140

Fax

(912) 287-1059

NPI assigned

Aug 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mayo Clinic Health System in Waycross, Inc.

  • Multi-Specialty Clinic/Center
  • Waycross, GA
  • NPI 1154745982
  NPD (past)
• McKinney Community Health Ctr, Inc

  • Federally Qualified Health Center (FQHC)
  • Blackshear, GA
  • NPI 1568623346
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215948260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 QUARTERMAN ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "31501",
            "telephone_number": "912-287-0301",
            "fax_number": "912-287-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 QUARTERMAN ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "31501",
            "telephone_number": "912-287-9140",
            "fax_number": "912-287-1059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3913 Main St",
            "address_purpose": "LOCATION",
            "city": "Folkston",
            "state": "GA",
            "postal_code": "315377545",
            "country_code": "US",
            "telephone_number": "912-496-0826",
            "fax_number": "912-496-6341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3919 Main St",
            "address_purpose": "LOCATION",
            "city": "Folkston",
            "state": "GA",
            "postal_code": "315377545",
            "country_code": "US",
            "telephone_number": "912-496-3426",
            "fax_number": "912-496-1072",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "711 Charles Gilman Jr Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Kingsland",
            "state": "GA",
            "postal_code": "315485664",
            "country_code": "US",
            "telephone_number": "912-510-9728",
            "fax_number": "912-510-9752",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9355 Main St S",
            "address_purpose": "LOCATION",
            "city": "Nahunta",
            "state": "GA",
            "postal_code": "315536159",
            "country_code": "US",
            "telephone_number": "912-462-6222",
            "fax_number": "912-462-6803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "EARL",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "028602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD GA",
            "identifier": "52407006",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10053757",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER ID",
            "identifier": "GRP2665",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000324156I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krupavathi Maramreddy, MD
• Padmanabh Maramreddy, M.D.
• Marc W. Eaton, PH.D., P.C.
• Charissa Marshall, LPN
• Andy M Martin, CRNA
• Kaitlyn Suzanne Martin, PTA
• Kristen Brooke Martin, APRN, FNP-C
• Virginia Martin, O.D.
• Ellisa A Mathis, FNP'C
• Kalie Deann Mathis, NP-C

• Family Medicine Physician in Waycross, GA
• Providers in Waycross, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.