John Edward Martin Sr., MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25229 Issued in GA

Practice address

1497 Fair Rd
Suite 103
Statesboro, GA 30458-0822

Phone

(912) 486-1163

Fax

(866) 795-4593

NPI assigned

Nov 7, 2006

Last updated

Sep 24, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

General Surgery

Education

Medical College of Georgia School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Shiloh Wound Care PC

  • Surgery Physician
  • Statesboro, GA
  • NPI 1073707436
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  Care Compare affiliation

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1316016819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 922088",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300102088",
            "telephone_number": "866-795-4593",
            "fax_number": "866-795-4593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 FAIR RD",
            "address_2": "SUITE 103",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580822",
            "telephone_number": "912-486-1163",
            "fax_number": "866-795-4593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "25229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1073707436",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000346376B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00387675",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Johnson Marsh
• Megan Elizabeth Marsh, FNP-BC
• Lexi Marshall, CRNA
• Thomas Elliott Marshall II, D.M.D.
• Alyssa Martin, AGACNP-BC
• Stephen R. Martin, DO, MPA, MSHSA
• Vincent Lee Martin, CHIROPRACTOR
• Kathryn Winn Marucco, PNP
• Richard F Marz, D.D.S.
• Chelsea Mason

• Surgery Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.