Active NPI
Geoffrey Martin
- Student in an Organized Health Care Education/Training Program
- Moultrie, GA
National Provider Identifier
1366186553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1937 S Main St
Moultrie, GA 31768-6523 - Phone
- (256) 684-7779
- NPI assigned
- Apr 24, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1937 S Main St
Moultrie, GA 31768-6523
Mailing address
1937 S Main St
Moultrie, GA 31768-6523
Phone (256) 684-7779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650758400000",
"number": "1366186553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1937 S MAIN ST",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317686523",
"telephone_number": "256-684-7779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1937 S MAIN ST",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317686523",
"telephone_number": "256-684-7779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "GEOFFREY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-24",
"last_updated": "2022-04-24",
"certification_date": "2022-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moultrie, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.