Active NPI
Adrian Theron Martin, MD
- Hospitalist Physician
- North Wilkesboro, NC
National Provider Identifier
1588209258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 2023-00800
- Practice address
- 1370 W D St
North Wilkesboro, NC 28659-3506 - Phone
- (336) 651-8294
- Fax
- (336) 681-8100
- NPI assigned
- Nov 16, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | LP04812 | RI | |
| Hospitalist Physician | 208M00000X | 2023-00800 | NC | Primary |
Addresses
Primary practice location
1370 W D St
North Wilkesboro, NC 28659-3506
Mailing address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 651-8294
Other practice location 1
825 Chalkstone Ave
Providence, RI 02908-4728
Phone (401) 456-2032
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240315000971 | NC | Practitioner - Hospitalist | 6002241015 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708473600000",
"number": "1588209258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-651-8294",
"fax_number": "336-651-8100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1370 W D ST",
"city": "NORTH WILKESBORO",
"state": "NC",
"postal_code": "286593506",
"telephone_number": "336-651-8294",
"fax_number": "336-681-8100"
}
],
"practiceLocations": [
{
"address_1": "825 Chalkstone Ave",
"address_purpose": "LOCATION",
"city": "Providence",
"state": "RI",
"postal_code": "029084728",
"country_code": "US",
"telephone_number": "401-456-2032",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTIN",
"first_name": "ADRIAN",
"middle_name": "THERON",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-11-16",
"last_updated": "2024-02-21",
"certification_date": "2024-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "RI",
"license": "LP04812",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NC",
"license": "2023-00800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Wilkesboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.