Martin Health

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MARTIN HEALTH

Doing business as

West Tennessee Medical Group Hillview South Clinic

Practice address

1135 Broadway Street
South Fulton, TN 38257-2835

Phone

(731) 479-2606

Fax

(731) 479-2610

NPI assigned

Oct 21, 2014

Last updated

Oct 14, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Tina Prescott

Title

President and Ceo

Phone

(731) 541-5000

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• West Tennessee Medical Group Hillview South Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669876520. Details of each certification follow.

• CCN 443449 Rural health clinic · Active · Details

Rural health clinic certification: CCN 443449

Legal name

MARTIN HEALTH

Doing business as

WEST TENNESSEE MEDICAL GROUP HILLVIEW SOUTH CLINIC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Feb 3, 2015

Last certification

Jan 21, 2025

Ownership / control type

2B

Organization structure

CorporationNon-profit

Enrollment address

1135 Broadway St
South Fulton, TN 38257-2835

Related CCNs

440061

Related certifications (CCN) 1

Facilities connected through Provider of Services related, parent or unit certification numbers.

• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372

  Parent provider

  Provider of Services

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372

  5193070613

  Same PAC ID
• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Martin, TN
  • NPI 1821060930

  5193070613

  Same PAC ID
• Martin Health

  dba West Tennessee Medical Group Primary Care Martin

  • Rural Health Clinic/Center
  • Martin, TN
  • NPI 1871034462

  5193070613

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Martin Health

  dba West Tennessee Medical Group Primary Care Martin

  • Rural Health Clinic/Center
  • Martin, TN
  • NPI 1871034462

  O20180925003822

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Martin Health5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital Pharmacy

  • Pharmacy
  • Martin, TN
  • NPI 1093582496
  NPD tax ID
• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372
  NPD tax ID
• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Martin, TN
  • NPI 1821060930
  NPD tax ID
• Martin Health

  dba West Tennessee Medical Group Primary Care Martin

  • Rural Health Clinic/Center
  • Martin, TN
  • NPI 1871034462
  NPD tax ID

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Martin, TN
  • NPI 1821060930

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Martin Health

  dba West Tennessee Medical Group Primary Care Martin

  • Rural Health Clinic/Center
  • Martin, TN
  • NPI 1871034462

  5% Or Greater Direct Ownership Interest

  CMS ownership

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Martin, TN
  • NPI 1821060930

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Martin Health

  dba West Tennessee Medical Group Primary Care Martin

  • Rural Health Clinic/Center
  • Martin, TN
  • NPI 1871034462

  5% Or Greater Direct Ownership Interest

  CMS ownership

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372

  Martin Health

  CMS ownership
• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Martin, TN
  • NPI 1821060930

  Martin Health

  CMS ownership
• Martin Health

  dba West Tennessee Medical Group Primary Care Martin

  • Rural Health Clinic/Center
  • Martin, TN
  • NPI 1871034462

  Martin Health

  CMS ownership

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Lee Bryant, MD

  • Family Medicine Physician
  • McKenzie, TN
  • NPI 1154324960
  Medicare reassignment Care Compare group NPD
• Fred Gregory Cox, MD

  • Internal Medicine Physician
  • South Fulton, TN
  • NPI 1104830801
  Medicare reassignment Care Compare group NPD
• Hunter J Crouse, DO

  • Family Medicine Physician
  • Martin, TN
  • NPI 1083363840
  Medicare reassignment Care Compare group NPD
• Elizabeth R Frazier, APRN

  • Nurse Practitioner
  • South Fulton, TN
  • NPI 1699789305
  Medicare reassignment Care Compare group NPD
• Kathryn J Glass, MD

  • Family Medicine Physician
  • Martin, TN
  • NPI 1679527923
  Medicare reassignment Care Compare group NPD
• Gregory Erwin Mitchell, MD

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1871596973
  Medicare reassignment Care Compare group NPD
• Amiee Foley Stooksberry, APRN

  • Nurse Practitioner
  • Martin, TN
  • NPI 1992919096
  Medicare reassignment Care Compare group NPD
• Joshua Drew Whitledge, DO

  • Family Medicine Physician
  • South Fulton, TN
  • NPI 1871596767
  Medicare reassignment Care Compare group NPD
• Grant Kneeland Studebaker, MD

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1265774236
  Medicare reassignment NPD
• Kimberly A Tilghman-Burch, MD

  • Pediatrics Physician
  • South Fulton, TN
  • NPI 1972585065
  Medicare reassignment NPD
• Justin Turner

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1235670647
  Medicare reassignment NPD
• Melissa Yvette Turner, FNP-C

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1467819748

  TN

  Medicare reassignment NPD

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1669876520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 BROADWAY STREET",
            "city": "SOUTH FULTON",
            "state": "TN",
            "postal_code": "382572835",
            "telephone_number": "731-479-2606",
            "fax_number": "731-479-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 BROADWAY STREET",
            "city": "SOUTH FULTON",
            "state": "TN",
            "postal_code": "382572835",
            "telephone_number": "731-479-2606",
            "fax_number": "731-479-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-21",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "PRESCOTT",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "731-541-5000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TN",
            "license": "0000000126",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044-3449",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q012738",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Tennessee Medical Group Hillview South Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacy Pope Hogan, MS,CCC-SLP
• Integrity-Park Terrace, LLC
• Karen Taylor Jones, RN
• Finley W Leslie, FNP
• Nasira M Malik, MD
• Martin Hospital Company, LLC (Hillview South)
• Pamela Suzette Milam, CNP
• Rice Mobile OD TN LLC
• Charles Avery Rice, OD
• Zearle Frances Robey

• Rural Health Clinic/Center in South Fulton, TN
• Providers in South Fulton, TN by specialty
• Rural Health Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.