Charlotte Marie Martin, CLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

326178

Practice address

2120 N Beltline Blvd Ste B
Columbia, SC 29204-4518

Phone

(803) 782-0528

Fax

(803) 782-0528

NPI assigned

Jul 13, 2021

Last updated

Jul 13, 2021By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1588236202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 E MAIN ST APT 1416",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290724278",
            "telephone_number": "803-466-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 N BELTLINE BLVD STE B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044518",
            "telephone_number": "803-782-0528",
            "fax_number": "803-782-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CHARLOTTE",
        "middle_name": "MARIE",
        "credential": "CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": "326178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clinicaladmin@southernrootsperio.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2120 N Beltline Blvd Ste B",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292044518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bradley Neal Martin, LMSW
• Brenda K. Martin, SOCIAL WORKER
• Breyon Martin
• Brianna Michelle Martin
• Chantel Renee Martin
• Christian Atlas Martin, M.A.T., PH.D., BCBA
• Courtney O. Martin, CCC-SLP
• Daniel John Martin, M.D.
• Gina Abbruzzi Martin, MD
• Jeffery Scott Martin, MD

• Lactation Consultant (Non-RN) in Columbia, SC
• Providers in Columbia, SC by specialty
• Lactation Consultant (Non-RN) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.