Martha Jefferson Medical Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MARTHA JEFFERSON MEDICAL GROUP LLC

Practice address

590 Peter Jefferson Pkwy Ste 300
Charlottesville, VA 22911-4628

Phone

(434) 654-7340

Fax

(434) 654-7752

NPI assigned

Oct 1, 2007

Last updated

Sep 29, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

MARTHA JEFFERSON HOSPITALAs reported in NPPES

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

Authorized official

Name

Dr. Bruce Clemons, MDNPI 1871536755

Title

Vice President, Medical Director

Phone

(434) 654-5229

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Part of

William H Murray MD

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Martha Jefferson Hospital

  • Cardiac Rehabilitation Clinic/Center
  • Charlottesville, VA
  • NPI 1285395459

  Member Of

  NPD member

Locations

Practitioners 334

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bruce D Clemons, MD

  • Internal Medicine Physician
  • Charlottesville, VA
  • NPI 1871536755
  Medicare reassignment Care Compare group NPD Authorized official
• Robert E Adams, MD

  • Neurology Physician
  • Charlottesville, VA
  • NPI 1003896762
  Medicare reassignment Care Compare group NPD
• Lindsay Alice Aguero, NP

  • Family Nurse Practitioner
  • Charlottesville, VA
  • NPI 1326270034
  Medicare reassignment Care Compare group NPD
• Rizwan Ahmed, M.D.

  • Gastroenterology Physician
  • Manassas, VA
  • NPI 1841469061
  Medicare reassignment Care Compare group NPD
• Shalom Sylvia Akauola, MD

  • Family Medicine Physician
  • Ruckersville, VA
  • NPI 1790289411
  Medicare reassignment Care Compare group NPD
• Mark Robert Anderson, M.D., M.SC.

  • Urology Physician
  • Charlottesville, VA
  • NPI 1922156181

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Francis Beckett Ansa, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Charlottesville, VA
  • NPI 1255427944
  Medicare reassignment Care Compare group NPD
• David Mark Arner, M.D.

  • Gastroenterology Physician
  • Newport News, VA
  • NPI 1851414262
  Medicare reassignment Care Compare group NPD
• Paul O Arnold, MD

  • Gastroenterology Physician
  • Manassas, VA
  • NPI 1992828693
  Medicare reassignment Care Compare group NPD
• Waseem Ismail Aziz, MD

  • Gastroenterology Physician
  • Fairfax, VA
  • NPI 1023038270
  Medicare reassignment Care Compare group NPD
• Anna B Baer, MD

  • Cardiovascular Disease Physician
  • Charlottesville, VA
  • NPI 1679553358
  Medicare reassignment Care Compare group NPD
• Deveryn Bailey, NP

  • Family Nurse Practitioner
  • Charlottesville, VA
  • NPI 1174094114
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1275720559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746550",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746550",
            "telephone_number": "434-654-7340",
            "fax_number": "434-654-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 PETER JEFFERSON PKWY STE 300",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114628",
            "telephone_number": "434-654-7340",
            "fax_number": "434-654-7752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA JEFFERSON MEDICAL GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARTHA JEFFERSON HOSPITAL",
        "enumeration_date": "2007-10-01",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "CLEMONS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VICE PRESIDENT, MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "434-654-5229",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Jefferson Hospital (Sentara Endoscopy Center)
• Martha Jefferson Hospital (MJ Reproductive Technology Lab)
• Martha Jefferson Hosptial (Martha Jefferson Nutritional Therapy)
• Martha Jefferson House
• Martha Jefferson House
• Martha Jefferson Medical Group LLC (Sentara Martha Jefferson Inpatient Services)
• Alyssa Martin
• Amy C. Martin, PA-C
• Andrew Noah Martin
• Ann Dabney Martin, NP

• Family Medicine Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.