Martin McClain Woolsey, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN21004 Issued in FL

Practice address

719 Bayshore Dr
Emerald Coast Periodontics
Niceville, FL 32578-2527

Phone

(850) 678-6485

Fax

(850) 678-5245

NPI assigned

Sep 17, 2012

Last updated

Feb 13, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Emerald Coast Periodontics

  • Periodontics
  • Niceville, FL
  • NPI 1306223888
  NPD (past) Authorized official
• Emerald Coast Periodontics, P.a.

  • Periodontics
  • Niceville, FL
  • NPI 1437201712
  NPD (past)

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644710400000",
    "number": "1588914543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 BAYSHORE DR",
            "address_2": "EMERALD COAST PERIODONTICS",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782527",
            "telephone_number": "850-678-6485",
            "fax_number": "850-678-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 BAYSHORE DR",
            "address_2": "EMERALD COAST PERIODONTICS",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782527",
            "telephone_number": "850-678-6485",
            "fax_number": "850-678-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLSEY",
        "first_name": "MARTIN",
        "middle_name": "MCCLAIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-17",
        "last_updated": "2022-02-13",
        "certification_date": "2022-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2012018306",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN21004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Anne' Wiseman, LMHC-S
• Laura Wittman
• Melodie A Wolf, ARNP
• Laura Woodard, DPT
• Casondra Woods, PT
• Andrew M Yang, MD
• Recelyn Aurora Yankauskas, LMT
• Ralf Peter Zapata, D.D.S.
• Stephen Joseph Zimmermann, MD
• Zook Chiropractic, P.a.

• Periodontics in Niceville, FL
• Providers in Niceville, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2022; 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.