NPIMap

Organization Active NPI

James T. Martin Jr. MD

  • Specialist
  • North Charleston, SC
National Provider Identifier
1679524888
Registry record updated Jun 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9818 Issued in SC
Legal business name
JAMES T. MARTIN JR. MD
Practice address
9213 University Blvd Ste a
Trident Executive Village
North Charleston, SC 29406-9145
Phone
(843) 572-7123
Fax
(843) 572-7350
NPI assigned
May 12, 2006
Last updated
Jun 23, 2017By the provider in NPPES
Organization subpart
No

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

Authorized official

Name
Mrs. Karla Allison Winningham
Title
Office Manager
Phone
(843) 572-7123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9818 SC Primary

Addresses

Primary practice location

9213 University Blvd Ste a
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 1

IdentifierTypeStateIssuer
9818-3MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060808000333 SC Part B Supplier - Clinic/Group Practice 0446253645 Receives reassigned benefits from 11 practitioners
Practice locations: North Charleston, SC

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D1074055James T Martin MD9213 University Blvd, Ste a, North Charleston, SC 29406Provider-performed microscopySep 20, 2027

National Provider Directory

National Provider Directory

Locations

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

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.654

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498176000000",
    "number": "1679524888",
    "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 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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES T. MARTIN JR. MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2017-06-23",
        "status": "A",
        "authorized_official_last_name": "WINNINGHAM",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "ALLISON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-572-7123",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "9818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9818-3",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.