Jennifer Ann Law Martin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001007100 Issued in NC

Practice address

167 Moore Rd Ste 206
King, NC 27021-8770

Phone

(336) 673-6450

Fax

(336) 673-6449

NPI assigned

Mar 30, 2017

Last updated

Aug 24, 2022By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group
• Forsyth Memorial Hospital, Inc.

  dba NH Forsyth Primary Care Clinics

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment
• Forsyth Memorial Hospital, Inc

  dba Novant Health Cardiology Clemmons

  • Cardiovascular Disease Physician
  • Clemmons, NC
  • NPI 1710382411
  NPD
• Forsyth Memorial Hospital, Inc.

  dba Novant Health Heart & Vascular Institute - Frontis Plaza

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1932935475
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Mountainview Medical Extended Care

  • Family Medicine Physician
  • King, NC
  • NPI 1245797745
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Pediatrics Blakeney

  • Pediatrics Physician
  • Charlotte, NC
  • NPI 1760989941
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Northlake Dermatology

  • Dermatopathology Physician
  • Huntersville, NC
  • NPI 1396751640
  NPD (past)

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1447782289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 MOORE RD STE 206",
            "city": "KING",
            "state": "NC",
            "postal_code": "270218770",
            "telephone_number": "336-673-6450",
            "fax_number": "336-673-6449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 Moore Rd",
            "address_purpose": "LOCATION",
            "city": "King",
            "state": "NC",
            "postal_code": "270218703",
            "country_code": "US",
            "telephone_number": "336-983-4346",
            "fax_number": "336-985-5101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Highland Oaks Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271037107",
            "country_code": "US",
            "telephone_number": "336-774-0040",
            "fax_number": "336-774-0029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 Moore Rd",
            "address_purpose": "LOCATION",
            "city": "King",
            "state": "NC",
            "postal_code": "270218703",
            "country_code": "US",
            "telephone_number": "336-983-4346",
            "fax_number": "336-985-5101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "167 Moore Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "King",
            "state": "NC",
            "postal_code": "27021",
            "country_code": "US",
            "telephone_number": "336-673-6450",
            "fax_number": "336-673-6449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JENNIFER",
        "middle_name": "ANN LAW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001007100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlaw143911@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "600 Highland Oaks Dr",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271037107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristy Lynette Mabe, LCSW
• Magnolia Eye Care, O.D. PLLC
• Sonja Makitan, OD
• Heidi C Marlowe-Rogers, MD
• Heather Marshall, PTA
• Corinne May
• Ashton McKinney, CNP
• Traci D McMillian, MD
• Medicomp, Inc. (Medicomp Physical Therapy King)
• Jaden Moore Miethe, NP

• Physician Assistant in King, NC
• Providers in King, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.