Erica Evans Martin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10176 Issued in GA

Practice address

1205 Town Park LN
Evans, GA 30809-3481

Phone

(706) 868-3100

NPI assigned

Feb 19, 2021

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: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Family Medical Center PCGroup PAC ID 5395715056, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: erica.martin.1@2561.direct.athenahealth.com

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.

• Southern Family Medical Center PC

  • Family Medicine Physician
  • Augusta, GA
  • NPI 1083785349
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1508459694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 RIVER NORTH DRIVE",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "29841",
            "telephone_number": "912-661-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 TOWN PARK LN",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093481",
            "telephone_number": "706-868-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ERICA",
        "middle_name": "EVANS",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Mann
• Logan Taylor Manning
• Andrea Lynn Manus, LCSW
• Mark a Benak MD PC
• Rachel S Marshall, PHRMD
• John Butler Martin, LCSW, MAC
• Kayleigh Martinez, RBT
• Saintete' Carter Martinez, DOULA
• Abby Mason
• Jordan Paul Mason, FNP

• Physician Assistant in Evans, GA
• Providers in Evans, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.
• 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.