Gaines C Martin MD PHD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GAINES C MARTIN MD PHD PA

Practice address

1409 Kingsley Ave Ste 9G
Orange Park, FL 32073-4579

Phone

(904) 637-0007

NPI assigned

Sep 11, 2007

Organization subpart

No

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

Authorized official

Name

Gaines Charles MartinNPI 1639103021

Title

Owner

Phone

(904) 637-0007

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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

• Gaines Charles Martin, MD

  • Family Medicine Physician
  • Orange Park, FL
  • NPI 1639103021
  Medicare reassignment NPD Authorized official
• Gaston Metelus, ARNP

  • Family Nurse Practitioner
  • Orange Park, FL
  • NPI 1235638602
  Medicare reassignment NPD
• Maureen Bond, LMFT, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1730250358
  NPD (past)

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586304000000",
    "number": "1265627541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 KINGSLEY AVE STE 9G",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734579",
            "telephone_number": "904-637-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 KINGSLEY AVE STE 9G",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734579",
            "telephone_number": "904-637-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAINES C MARTIN MD PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "GAINES",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-637-0007"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Francisco Fuentes, DO
• Full Circle Counseling Services, LLC
• Full Connections Counseling
• Courtney Fuller
• Functional Kids Therapy LLC
• Andrea Gainey, PTA
• Gaither Counseling & Wellness, LLC
• Maria Galarza
• Sabrina Gale
• Makayla Gallarde

• Family Medicine Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.