Individual provider Active NPI

Martha Sandra Amaya

  • Specialist
  • Calhoun, GA
National Provider Identifier
1669806121
Registry record updated Sep 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MT009079 Issued in GA
Practice address
108 Oothcalooga St
Calhoun, GA 30701-2332
Phone
(706) 844-2172
NPI assigned
Sep 2, 2013
Last updated
Sep 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MT009079 GA Primary

Addresses

Primary practice location

108 Oothcalooga St
Calhoun, GA 30701-2332

Mailing address

620 Johnson Lake Rd SE
Adairsville, GA 30103-3707
Phone (706) 844-2172

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MT009079GAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1378080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378080000000",
    "number": "1669806121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 JOHNSON LAKE RD SE",
            "city": "ADAIRSVILLE",
            "state": "GA",
            "postal_code": "301033707",
            "telephone_number": "706-844-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 OOTHCALOOGA ST",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307012332",
            "telephone_number": "706-844-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAYA",
        "first_name": "MARTHA",
        "middle_name": "SANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-02",
        "last_updated": "2013-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "MT009079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calhoun, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2013; 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.