Ola Jenelle Martin, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

034660 Issued in GA

Practice address

3469 Lawrenceville Hwy
Suite 103
Tucker, GA 30084-5888

Phone

(770) 638-1960

Fax

(770) 638-1961

NPI assigned

Sep 14, 2006

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

• Jenelle Martin Professional name

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

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 and National Provider Directory roles.

• Georgia Health Partners

  • Community/Behavioral Health Agency
  • Tucker, GA
  • NPI 1376780361
  Medicare reassignment NPD
• Jenelle Martin, M.D., P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucker, GA
  • NPI 1710239942
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1366547002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 PINETREE PASS LN SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "30047",
            "telephone_number": "770-638-1960",
            "fax_number": "770-638-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3469 LAWRENCEVILLE HWY",
            "address_2": "SUITE 103",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845888",
            "telephone_number": "770-638-1960",
            "fax_number": "770-638-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "OLA",
        "middle_name": "JENELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "034660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00599915E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENELLE",
            "last_name": "MARTIN",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Joseph Louis Marrocco, RPH
• Robert W Marsh, D.O.
• Bessie Martin-Jackson
• Katelyn Martin
• Kristi Martin
• Aditya Marwaha, D.O.
• Lacy Elizabeth Mason, PT, DPT
• Rebecca Slocum Mason
• Massage Associates of Atlanta, LLC
• Masvida Health Care Solutions, LLC

• Psychiatry Physician in Tucker, GA
• Providers in Tucker, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.