Individual provider Active NPI

James Thomas Martin Jr., M.D.

  • Obstetrics & Gynecology Physician
  • North Charleston, SC
National Provider Identifier
1659345494
Registry record updated Jun 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
9818 Issued in SC
Practice address
9213 A. University Blvd.
Trident Executive Village
North Charleston, SC 29406-9145
Phone
(843) 572-7123
Fax
(843) 572-7350
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 9818 SC Primary

Addresses

Primary practice location

9213 A. University Blvd.
Trident Executive Village
North Charleston, SC 29406-9145

Mailing address

9213 University Blvd Ste a
Trident Executive Village
North Charleston, SC 29406-9145
Phone (843) 572-7123

Other identifiers 3

IdentifierTypeStateIssuer
1679524888OtherSCNPI
098183MedicaidSC
GP4430 (474430)MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060712000296 SC Practitioner - Obstetrics/Gynecology 5193719615 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical University of South Carolina College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9213 University Blvd
Suite a
North Charleston, SC 29406-9145
Phone (843) 572-7123

Hospital & facility affiliations

  • Trident Medical Center Hospital, Charleston, SC, CCN 420079

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9818SCMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network Obstetrics & Gynecology CurrentSince Jun 23, 2020 Accepting new patients
Roper Saint Francis Physicians Network Current Accepting new patients
James T. Martin Jr. MD CurrentSince May 1, 2006 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jun 23, 2020 Accepting new patients

Locations

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

8536 Palmetto Commerce Pkwy
Ste 401
Ladson, SC 29456
Phone (843) 203-2260

9213 University Blvd
Ste A
North Charleston, SC 29406
Phone (843) 569-2900

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Interoperability endpoints

  • Direct secure messaging: martin@jmartin.gwaydirect.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.654

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1659345494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9213 UNIVERSITY BLVD STE A",
            "address_2": "TRIDENT EXECUTIVE VILLAGE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069145",
            "telephone_number": "843-572-7123",
            "fax_number": "843-572-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9213 A. UNIVERSITY BLVD.",
            "address_2": "TRIDENT EXECUTIVE VILLAGE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069145",
            "telephone_number": "843-572-7123",
            "fax_number": "843-572-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JAMES",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "9818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1679524888",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098183",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4430 (474430)",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.