Theresa A Martin, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

J6565 Issued in TX

Practice address

802 Medical Dr Ste 200
Longview, TX 75605-5201

Phone

(903) 232-8297

Fax

(903) 553-7751

NPI assigned

Mar 7, 2006

Last updated

Aug 26, 2020By the provider in NPPES

Sex

Female

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23550/brand/1/csg/1/fhir/r4
• Direct secure messaging: theresa.martin.1@16432.direct.athenahealth.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.

• Diagnostic Clinic of Longview PA

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1386638468

  Obstetrics & Gynecology

  NPD (past)
• Longview Wellness Center Inc

  dba Wellness Pointe

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1447910542

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1255308508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19036",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154085",
            "telephone_number": "903-381-7263",
            "fax_number": "903-381-7269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 MEDICAL DR STE 200",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055201",
            "telephone_number": "903-232-8297",
            "fax_number": "903-553-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "THERESA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "J6565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105981808",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "theresa.martin.1@16432.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "802 Medical Dr Ste 200",
            "city": "Longview",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756055201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Allyson Tilley Martin, PHARMD
• Baylee Martin, LPC
• Charles R Martin, MD
• Kenneth Martin Jr., AU.D.
• Laura McAlpin Martin, M.D.
• Abigail Renae Martinez
• Joshua Shane Martinez, LCDC-I, MHPS, CHW
• Radames Martinez Jr., MD
• Mary K McGee, MD
• Athena Mask, MT-BC

• Obstetrics & Gynecology Physician in Longview, TX
• Providers in Longview, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.