Individual provider Active NPI

Zachary B Martin Jr., M.D.

  • Diagnostic Radiology Physician
  • Rome, GA
National Provider Identifier
1679645022
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
035471 Issued in GA
Practice address
255 W 5TH St SW
Suite 150
Rome, GA 30165-2817
Phone
(706) 232-1545
Fax
(706) 232-3819
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 035471 GA
Neuroradiology Physician 2085N0700X 035471 GA
Nuclear Radiology Physician 2085N0904X 035471 GA
Pediatric Radiology Physician 2085P0229X 035471 GA
Diagnostic Radiology Physician 2085R0202X 035471 GA Primary
Therapeutic Radiology Physician 2085R0203X 035471 GA
Vascular & Interventional Radiology Physician 2085R0204X 035471 GA
Diagnostic Ultrasound Physician 2085U0001X 035471 GA

Addresses

Primary practice location

255 W 5TH St SW
Suite 150
Rome, GA 30165-2817

Mailing address

PO Box 369
Rome, GA 30162-0369
Phone (706) 291-2077

Other identifiers 3

IdentifierTypeStateIssuer
000494777AMedicaidGA
300034704OtherGARAILROAD MEDICARE
027195OtherGABCBS OF GEORGIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060125000497 GA Practitioner - Diagnostic Radiology 6709800048 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rome Imaging Associates Nuclear Radiology CurrentSince Jul 1, 1966 Accepting new patients
Rome Radiology Group, PA Body Imaging CurrentSince Apr 2, 1992 Accepting new patients

Locations

255 W 5th St SW
Ste 150
Rome, GA 30165
Phone (706) 232-1545

1104 Martha Berry Blvd NE
Rome, GA 30165
Phone (706) 291-2077

1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073

901 N Broad St NE
Ste 220
Rome, GA 30161
Phone (706) 291-2077

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1679645022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620369",
            "telephone_number": "706-291-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W 5TH ST SW",
            "address_2": "SUITE 150",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652817",
            "telephone_number": "706-232-1545",
            "fax_number": "706-232-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ZACHARY",
        "middle_name": "B",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "GA",
            "license": "035471",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "GA",
            "license": "035471",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "GA",
            "license": "035471",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "GA",
            "license": "035471",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "035471",
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "GA",
            "license": "035471",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "035471",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "GA",
            "license": "035471",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000494777A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300034704",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GEORGIA",
            "identifier": "027195",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.