Martina A Green-McGowan, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

01041734 Issued in IN

Practice address

236 Simpson Ave
Elkhart, IN 46516

Phone

(574) 293-0052

Fax

(574) 293-3744

NPI assigned

Jun 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Martina G McGowan Professional name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: martina.mcgowan.1@11397.direct.athenahealth.com

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Heart City Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Elkhart, IN
  • NPI 1295143774

  Corporate Officer, Operational/Managerial Control

  CMS ownership
• Heart City Health Center, Inc.

  • Community Health Clinic/Center
  • Elkhart, IN
  • NPI 1720033418

  Corporate Officer, Operational/Managerial Control

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Heart City Health Center, Inc.

  • Community Health Clinic/Center
  • Elkhart, IN
  • NPI 1720033418

  IN

  Medicare reassignment NPD
• Heart City Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Elkhart, IN
  • NPI 1861034688

  Obstetrics & Gynecology

  NPD
• Elkhart General Hospital, Inc.

  • General Acute Care Hospital
  • Elkhart, IN
  • NPI 1477551489
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1295739639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 SIMPSON AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465164666",
            "telephone_number": "574-293-0052",
            "fax_number": "574-293-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 SIMPSON AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "46516",
            "telephone_number": "574-293-0052",
            "fax_number": "574-293-3744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1122 Professional Dr",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465263819",
            "country_code": "US",
            "telephone_number": "574-533-0560",
            "fax_number": "574-533-1716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "236 Simpson Ave",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "46516",
            "country_code": "US",
            "telephone_number": "574-293-0052",
            "fax_number": "574-293-3744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN-MCGOWAN",
        "first_name": "MARTINA",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01041734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100357660",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTINA",
            "last_name": "MCGOWAN",
            "middle_name": "G",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Graceful Came in Home LLC
• Graceful Came in Home LLC
• Tatiana Vasilievna Graham, PHARMACIST
• Nicole R Graves, NP
• Great Lakes Anesthesia, P.C.
• Denise E Green
• Joy Greeney
• Greenleaf Family Dentistry
• Clayton Greer
• Greg M. Mielke, M.D., P.C.

• All providers in Elkhart, IN
• Obstetrics & Gynecology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.