Corey Andre' Martin Sr., PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA005116 Issued in GA

Practice address

1240 Floy Farr Parkway
Suite 404
Fayetteville, GA 30214

Phone

(470) 670-0485

NPI assigned

Aug 9, 2023

Last updated

Aug 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1366125072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3690 SPRINGSIDE LN",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493550",
            "telephone_number": "404-825-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 FLOY FARR PARKWAY",
            "address_2": "SUITE 404",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "470-670-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "COREY",
        "middle_name": "ANDRE'",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA005116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Marshall, SLP
• Zwade J Marshall, M.D.
• Martha a Schuh, MD (Peachtree Immediate Care and Occupational Medicine)
• Ashley Martin, LPC,BCBA,LBA, CMAC,
• Carol D Martin, NP
• Felice Martin
• Maurice Martin II, MT
• William Darrell Martin, M.D.
• Caleb I Martinez Lazo, CAA
• Erin Martinez

• Physical Therapy Assistant in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.