Individual provider Active NPI

Emily Grace Martin, RD, LD

  • Registered Dietitian
  • Varnville, SC
National Provider Identifier
1316776115
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86171031 Issued in SC
Practice address
595 W Carolina Ave
Varnville, SC 29944-4735
Phone
(803) 943-2771
NPI assigned
Jul 30, 2024
Last updated
Jul 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86171031 SC Primary

Addresses

Primary practice location

595 W Carolina Ave
Varnville, SC 29944-4735

Mailing address

595 W Carolina Ave
Varnville, SC 29944-4735
Phone (803) 943-2771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250320002504 SC Practitioner - Registered Dietitian Or Nutrition Professional 9537681366 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86171031SCMDRegistered Dietitian
2761SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Plains Physician Associates CurrentSince Dec 27, 2024 Accepting new patients

Locations

595 W Carolina Ave
Varnville, SC 29944
Phone (803) 943-1221

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": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1316776115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 W CAROLINA AVE",
            "city": "VARNVILLE",
            "state": "SC",
            "postal_code": "299444735",
            "telephone_number": "803-943-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 W CAROLINA AVE",
            "city": "VARNVILLE",
            "state": "SC",
            "postal_code": "299444735",
            "telephone_number": "803-943-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "EMILY",
        "middle_name": "GRACE",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "86171031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Varnville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.