Active NPI
Joshlyn Carlissa Martin
- Physical Therapist
- Greenville, SC
National Provider Identifier
1679349369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12129
- Practice address
- 3400 Anderson Rd
Greenville, SC 29611-7651 - Phone
- (864) 295-9890
- NPI assigned
- Dec 4, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12129 | SC | Primary |
Addresses
Primary practice location
3400 Anderson Rd
Greenville, SC 29611-7651
Mailing address
507 Baycraft LN
Simpsonville, SC 29681-7158
Phone (864) 380-3377
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12129 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701648000000",
"number": "1679349369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 BAYCRAFT LN",
"city": "SIMPSONVILLE",
"state": "SC",
"postal_code": "296817158",
"telephone_number": "864-380-3377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 ANDERSON RD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296117651",
"telephone_number": "864-295-9890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JOSHLYN",
"middle_name": "CARLISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-04",
"last_updated": "2023-12-04",
"certification_date": "2023-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "12129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.