Jamita Martin

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

LC20150000857 Issued in GA

Practice address

6468 Hwy 92
Suite 140
Acworth, GA 30102-0005

Phone

(770) 634-9994

Fax

(855) 413-6890

NPI assigned

Dec 30, 2015

Sex

Female

Sole proprietor

Yes

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

Practice roles

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.

• Bhi Outlet Inc

  • Intellectual & Developmental Disabilities Psychologist
  • Woodstock, GA
  • NPI 1215711122
  NPD Authorized official

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1366807778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2298",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301020005",
            "telephone_number": "770-634-9994",
            "fax_number": "855-413-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6468 HWY 92",
            "address_2": "SUITE 140",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301020005",
            "telephone_number": "770-634-9994",
            "fax_number": "855-413-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JAMITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "LC20150000857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marietta Eye Clinic
• Marietta Eye Optical Inc
• Mark a Lipschitz DC, P.C.
• Tye Marr, PT
• Cara Martin
• Jason Alan Martin, DPT
• Melissa B Martin, PT
• Ralph Henry Martin, DO
• Ronald Tyler Martin
• Sara Hines Martin, M.S. COUNSELOR

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Acworth, GA
• Providers in Acworth, GA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.