Jackie N Marshall-Martin, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN159956 Issued in GA

Practice address

3991 Highway 78 W Ste 203
Snellville, GA 30039-3929

Phone

(770) 978-9393

NPI assigned

Nov 7, 2017

Last updated

Jul 15, 2025By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.jackmarshallmartin@124220.advancedmd-direct.com

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.

• Uhs of Peachford LP

  dba Peachford Behavioral Health System of Atlanta

  • Psychiatry Physician
  • Atlanta, GA
  • NPI 1124207220
  Medicare reassignment NPD
• Uhs of Peachford LP

  dba Peachford Apothecary

  • Community/Retail Pharmacy
  • Atlanta, GA
  • NPI 1861978793
  NPD
• Uhs of Peachford, L.P.

  dba Peachford Behavioral Health System of Atlanta

  • Psychiatric Hospital
  • Atlanta, GA
  • NPI 1093781544
  NPD (past)

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1245743756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630",
            "telephone_number": "770-978-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3991 HIGHWAY 78 W STE 203",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300393929",
            "telephone_number": "770-978-9393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2151 Peachford Rd",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303386534",
            "country_code": "US",
            "telephone_number": "770-455-5519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 Willie Kate Ln",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300453534",
            "country_code": "US",
            "telephone_number": "404-664-9864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL-MARTIN",
        "first_name": "JACKIE",
        "middle_name": "N",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN159956",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN159956",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jasmine Marshall, M.D.
• Dayna R Martin
• Elise Danielle Martin, MD
• Jessica Martin, RBT
• Tiana Marie Martin

• Psychiatric/Mental Health Nurse Practitioner in Snellville, GA
• Providers in Snellville, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.