Derrick J Martin MD PA

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

ME100133 Issued in FL

Legal business name

DERRICK J MARTIN MD PA

Practice address

1501 N US Highway 441
BLDG 1800 Suite 1832
The Villages, FL 32159-8999

Phone

(352) 751-8833

NPI assigned

Apr 16, 2008

Last updated

Apr 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Derrick J Martin Sr., MD

Title

Physician

Phone

(352) 751-8833

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1568636967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N US HIGHWAY 441",
            "address_2": "BLDG 1800 SUITE 1832",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321598999",
            "telephone_number": "352-751-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N US HIGHWAY 441",
            "address_2": "BLDG 1800 SUITE 1832",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321598999",
            "telephone_number": "352-751-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERRICK J MARTIN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "352-751-8833",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "FL",
            "license": "ME100133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0803330",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Acute Care Hospital in The Villages, FL
• Providers in The Villages, FL by specialty
• General Acute Care Hospital in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.