NPIMap

Organization Active NPI

M.J. Martelli, M.D.

  • Psychiatry Physician
  • Brunswick, GA
National Provider Identifier
1265613277
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
032428 Issued in GA
Legal business name
M.J. MARTELLI, M.D.
Practice address
7 Saint Andrews CT
Brunswick, GA 31520-6764
Phone
(912) 267-0774
Fax
(912) 267-9552
NPI assigned
Nov 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2007

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

Authorized official

Name
Miguel Jose Martelli, M.D.
Title
Owner
Phone
(912) 267-0774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 032428 GA Primary

Addresses

Primary practice location

7 Saint Andrews CT
Brunswick, GA 31520-6764

Mailing address

7 Saint Andrews CT
Brunswick, GA 31520-6764
Phone (912) 267-0774

Other identifiers 1

IdentifierTypeStateIssuer
00415737AMedicaidGA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1265613277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SAINT ANDREWS CT",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315206764",
            "telephone_number": "912-267-0774",
            "fax_number": "912-267-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 SAINT ANDREWS CT",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315206764",
            "telephone_number": "912-267-0774",
            "fax_number": "912-267-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.J. MARTELLI, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "MARTELLI",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-267-0774",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "032428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00415737A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.