Individual provider Active NPI

Martin C Laxson, PA

  • Surgical Physician Assistant
  • Gainesville, GA
National Provider Identifier
1275714701
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
002522 Issued in GA
Practice address
1315 Jesse Jewell Pkwy NE Ste 201
Gainesville, GA 30501-3822
Phone
(770) 219-8765
NPI assigned
Nov 27, 2007
Last updated
Nov 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 002522 GA
Surgical Physician Assistant 363AS0400X 002522 GA Primary

Addresses

Primary practice location

1315 Jesse Jewell Pkwy NE Ste 201
Gainesville, GA 30501-3822

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

1404 River Pl Ste 301
Braselton, GA 30517-5600
Phone (770) 219-8765

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlaxson29976@nghs.gadirect.net Direct

Medicare participation

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

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002522GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc CurrentSince Feb 1, 2010 Accepting new patients

Locations

1404 River Pl
Ste 301
Braselton, GA 30517
Phone (770) 219-8765

1240 Jesse Jewell Pkwy SE
Ste 200
Gainesville, GA 30501
Phone (770) 532-8438

1315 Jesse Jewell Pkwy NE
Ste 201
Gainesville, GA 30501
Phone (770) 219-8765

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

Interoperability endpoints

  • Direct secure messaging: mlaxson29976@nghs.gadirect.net

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": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1275714701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 JESSE JEWELL PKWY NE STE 201",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013822",
            "telephone_number": "770-219-8765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1404 River Pl Ste 301",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175600",
            "country_code": "US",
            "telephone_number": "770-219-8765",
            "fax_number": "770-219-3707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAXSON",
        "first_name": "MARTIN",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-27",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "002522",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "002522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlaxson29976@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1315 Jesse Jewell Pkwy NE Ste 201",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.