Dallas B Martin, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1048 Issued in WV

Practice address

1106 Skytop Cir
Charleston, WV 25314-2222

Phone

(304) 610-3704

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 10, 2016 through Nov 10, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Emcare Physician Providers Inc.

  • Emergency Medicine Physician
  • Montgomery, WV
  • NPI 1982615225
  NPD (past)
• Greenbrier Emergency Services, Inc.

  • Emergency Medicine Physician
  • Gassaway, WV
  • NPI 1568401461
  NPD (past)
• Teays Valley Emergency Physicians, Inc

  • Emergency Medicine Physician
  • Hurricane, WV
  • NPI 1386760502
  NPD (past)
• West Virginia Em-I Medical Services

  • Emergency Medicine Physician
  • Summersville, WV
  • NPI 1598148553
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1679590202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 SKYTOP CIR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253142222",
            "telephone_number": "304-610-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 SKYTOP CIR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253142222",
            "telephone_number": "304-610-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DALLAS",
        "middle_name": "B",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "1048",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0042041000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Martin
• Breanna Martin
• Caleb Hunter Holswade Martin, DO
• Carrie Michelle Martin
• Cynthia Martin
• Darcas E Martin
• De'Auja Martin
• Denise Martin
• Diana Joyce Martin, M.D.
• Dylan S Martin

• Family Medicine Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.