Kimberly Lisle Martin, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC003867 Issued in GA

Practice address

323 Roland Rd
Jasper, GA 30143-5336

Phone

(706) 253-1112

Fax

(706) 253-1120

NPI assigned

May 21, 2012

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

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Highland Rivers Community Service BoardGroup PAC ID 9032000245, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Highland Rivers Community Service Board

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1447256243
  Medicare reassignment Care Compare group NPD
• Highland Rivers CSB

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1164585543
  NPD

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1437419702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 ROLAND RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301435336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 ROLAND RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301435336",
            "telephone_number": "706-253-1112",
            "fax_number": "706-253-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KIMBERLY",
        "middle_name": "LISLE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC003867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M & M Interventional Spine
• Ismarie Mabry, LCSW
• Khawaja R Mahmood, M.D.
• Patrick S Malone, DPM
• Karl Mareth, MD
• Victoria Martin
• Mary Kathleen West LCSW, Inc
• Scott Masson, D.O.
• Moiz Vasim Master, M.D.
• Mastercare Medical Center

• Professional Counselor in Jasper, GA
• Providers in Jasper, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.