Martha E Hackett, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35 043939-H Issued in OH

Practice address

8300 Tyler Blvd Ste 300
Mentor, OH 44060-4251

Phone

(440) 205-1529

Fax

(440) 205-0840

NPI assigned

Aug 15, 2005

Last updated

Mar 3, 2021By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: martha.hackett@lhpg.cernerdirect.com

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.

• Lake Hospital System Inc

  • Family Medicine Physician
  • Middlefield, OH
  • NPI 1952339996
  Medicare reassignment NPD
• Lake Hospital System, Inc

  dba Lake Health Urgent Care and Walk In Center

  • Urgent Care Clinic/Center
  • Mentor, OH
  • NPI 1205896404
  NPD
• Lake Hospital System, Inc

  dba Lake Health Urgent Care and Walk In Clinic

  • Urgent Care Clinic/Center
  • Chardon, OH
  • NPI 1689634966

  Family Medicine

  NPD

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1467454975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7590 AUBURN ROAD, SUITE 014",
            "address_2": "ATTN: MED STAFF",
            "city": "CONCORD TWP",
            "state": "OH",
            "postal_code": "440779176",
            "telephone_number": "440-354-1899",
            "fax_number": "440-354-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 TYLER BLVD STE 300",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604251",
            "telephone_number": "440-205-1529",
            "fax_number": "440-205-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKETT",
        "first_name": "MARTHA",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35 043939-H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0484042",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Martha.Hackett@lhpg.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Baseline West Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "8300 Tyler Blvd Ste 300",
            "city": "Mentor",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440604251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Guhl, LISW
• Annmarie Gunsch, MSSA LISW
• Daniel Philip Gura, CDCA
• Deborah L Gurney, LISW-S
• Hackett Medical LTD
• Dyan M Hagy, LSW
• Courtney A Hale
• Gwen Hale
• Laquita Hall-Cortes
• Amy Marie Hall, LPCC, LLC

• Family Medicine Physician in Mentor, OH
• Providers in Mentor, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.