Individual provider Active NPI

Hailee Ann Martin, PA-C

  • Family Medicine Physician
  • Hampstead, NC
National Provider Identifier
1255080453
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0010-12597 Issued in NC
Practice address
2540 NC Highway 210 E
Hampstead, NC 28443-8988
Phone
(910) 329-9916
Fax
(910) 329-9919
NPI assigned
Mar 23, 2022
Last updated
Sep 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 0010-12597 NC Primary

Addresses

Primary practice location

2540 NC Highway 210 E
Hampstead, NC 28443-8988

Mailing address

PO Box 2400
Surf City, NC 28445-0027
Phone (910) 329-9916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230302002669 NC Practitioner - Physician Assistant 7012380579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Island Family Medicine PLLCGroup PAC ID 8123156445, 4 clinicians

Practice addresses (Care Compare)

13567A NC Hwy 50
Surf City, NC 28445-6555
Phone (910) 329-9916

2540 NC Hwy 210 E
Hampstead, NC 28443-8988
Phone (910) 329-9916

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-12597NCMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: hailee.martin.1@2452.direct.athenahealth.com

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.

Hospital & facility affiliations 4

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": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1255080453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2400",
            "city": "SURF CITY",
            "state": "NC",
            "postal_code": "284450027",
            "telephone_number": "910-329-9916",
            "fax_number": "910-329-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 NC HIGHWAY 210 E",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284438988",
            "telephone_number": "910-329-9916",
            "fax_number": "910-329-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "HAILEE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "0010-12597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampstead, NC

Sources for this page

Verify at the official NPI Registry.