Individual provider Active NPI

Martha Monson Sribnick, MD

  • Pediatric Adolescent Medicine Physician
  • Fort Jackson, SC
National Provider Identifier
1255422184
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
8140 Issued in SC
Practice address
4500 Stuart Street
Moncrief Army Community Hosptial/Credentials
Fort Jackson, SC 29207-5720
Phone
(803) 751-2618
Fax
(803) 751-2689
NPI assigned
Sep 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 8140 SC Primary

Addresses

Primary practice location

4500 Stuart Street
Moncrief Army Community Hosptial/Credentials
Fort Jackson, SC 29207-5720

Mailing address

4500 Stuart Street
Moncrief Army Community Hosptial, Attn: MCXL-PQ (Cred)
Fort Jackson, SC 29207-5720
Phone (803) 751-2618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8140SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255422184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 STUART STREET",
            "address_2": "MONCRIEF ARMY COMMUNITY HOSPTIAL, ATTN: MCXL-PQ (CRED)",
            "city": "FORT JACKSON",
            "state": "SC",
            "postal_code": "292075720",
            "telephone_number": "803-751-2618",
            "fax_number": "803-751-2689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 STUART STREET",
            "address_2": "MONCRIEF ARMY COMMUNITY HOSPTIAL/CREDENTIALS",
            "city": "FORT JACKSON",
            "state": "SC",
            "postal_code": "292075720",
            "telephone_number": "803-751-2618",
            "fax_number": "803-751-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIBNICK",
        "first_name": "MARTHA",
        "middle_name": "MONSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "SC",
            "license": "8140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Jackson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.