Individual provider Active NPI

Jessica Anika Farmer Martin, APRN

  • Family Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1255750808
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23854 Issued in SC
Practice address
2420 Andrews Rd
Spartanburg, SC 29302-6300
Phone
(864) 494-8032
NPI assigned
Apr 10, 2014
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23854 SC Primary

Addresses

Primary practice location

2420 Andrews Rd
Spartanburg, SC 29302-6300

Mailing address

210 Golden Pond CT
Roebuck, SC 29376-2777

Other practice location 1

3070 Reidville Rd
Spartanburg, SC 29301-5642
Phone (864) 576-5764

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20220721003584 SC Practitioner - Nurse Practitioner 8820479801 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23854SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Internal Medicine, LLC CurrentSince Sep 6, 2024 Accepting new patients
Ingenios Health Co. CurrentSince Sep 6, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Aug 29, 2024 Accepting new patients
State of South Carolina PastSince Dec 6, 2020 Accepting new patients
State of South Carolina Comptroller General Past Accepting new patients

Locations

2 Office Park Ct
Ste 103
Columbia, SC 29223
Phone (505) 340-5555

3070 Reidville Rd
Spartanburg, SC 29301
Phone (846) 576-5764

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 5

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": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1255750808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 GOLDEN POND CT",
            "city": "ROEBUCK",
            "state": "SC",
            "postal_code": "293762777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 ANDREWS RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293026300",
            "telephone_number": "864-494-8032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3070 Reidville Rd",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293015642",
            "country_code": "US",
            "telephone_number": "864-576-5764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JESSICA",
        "middle_name": "ANIKA FARMER",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "23854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.