Individual provider Active NPI

Martha Lynn Jackman, CNP

  • Adult Health Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1447502224
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN-NP218645 Issued in GA
Practice address
631 Professional Dr Ste 360
Lawrenceville, GA 30046-3370
Phone
(678) 312-3290
Fax
(678) 312-2733
NPI assigned
Oct 4, 2012
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN-NP218645 GA Primary

Addresses

Primary practice location

631 Professional Dr Ste 360
Lawrenceville, GA 30046-3370

Mailing address

631 Professional Dr Ste 360
Lawrenceville, GA 30046-3370
Phone (678) 312-3290

Other names 1

  • Martha Lynn Stewart Former name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150304001844 GA Practitioner - Nurse Practitioner 1355667676 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gwinnett Pulmonary GroupGroup PAC ID 1153317615, 17 clinicians
Gwinnett Physician Group, LLCGroup PAC ID 9133211139, 112 clinicians

Practice addresses (Care Compare)

631 Professional Dr
Suite 350
Lawrenceville, GA 30046-3370
Phone 7709950630135

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.86 of 100Reported as group
Quality
70.36
Promoting interoperability
100
Improvement activities
40
Cost
77.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-NP218645GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gwinnett Physician Group, LLC CurrentSince Oct 14, 2025 Accepting new patients
Gwinnett Pulmonary Group Duluth Current Accepting new patients
Gwinnett Pulmonary Group CurrentSince Sep 30, 2014 Accepting new patients
Gwinnett Medical Group, Inc Past Accepting new patients

Locations

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

631 Professional Dr
Ste 350
Lawrenceville, GA 30046
Phone (770) 995-0630

631 Professional Dr
Ste 360
Lawrenceville, GA 30046
Phone (678) 312-3290

Interoperability endpoints

  • Direct secure messaging: martha.stewart.1@14769.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1447502224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR STE 360",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463370",
            "telephone_number": "678-312-3290",
            "fax_number": "678-312-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR STE 360",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463370",
            "telephone_number": "678-312-3290",
            "fax_number": "678-312-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKMAN",
        "first_name": "MARTHA",
        "middle_name": "LYNN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "APRN-NP218645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "STEWART",
            "middle_name": "LYNN",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.