Active NPI
Martin Jourden, D.O.
- Obstetrics & Gynecology Physician
- Petersburg, VA
National Provider Identifier
1609843994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 102201039
- Practice address
- 50 Medical Park Blvd.
Suite a
Petersburg, VA 23805-9274 - Phone
- (804) 732-1286
- NPI assigned
- Mar 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 102201039 | VA | Primary |
Addresses
Primary practice location
50 Medical Park Blvd.
Suite a
Petersburg, VA 23805-9274
Mailing address
PO Box 203
Prince George, VA 23875-0203
Phone (804) 541-6666
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6204503 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102201039 | VA | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1609843994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 203",
"city": "PRINCE GEORGE",
"state": "VA",
"postal_code": "238750203",
"telephone_number": "804-541-6666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 MEDICAL PARK BLVD.",
"address_2": "SUITE A",
"city": "PETERSBURG",
"state": "VA",
"postal_code": "238059274",
"telephone_number": "804-732-1286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOURDEN",
"first_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-05",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "VA",
"license": "102201039",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6204503",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Petersburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.