Active NPI
Davis Martin
- Occupational Therapist
- Woodstock, GA
National Provider Identifier
1689366262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 489346
- Practice address
- 4580 Towne Lake Pkwy
Woodstock, GA 30189-5521 - Phone
- (678) 771-6459
- NPI assigned
- May 23, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 489346 | AL | Primary |
Addresses
Primary practice location
4580 Towne Lake Pkwy
Woodstock, GA 30189-5521
Mailing address
2508 Aycock Cemetery Road
Leighton, AL 35646
Phone (970) 417-7462
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Somerby Dr
Alpharetta, GA 30009-8780
Phone (770) 585-1151
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 489346 | AL | MD | Occupational Therapist |
Organizations & group practices 1
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.
-
- Physical Therapist
- Alpharetta, GA
- NPI 1851265755
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1689366262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2508 AYCOCK CEMETERY ROAD",
"city": "LEIGHTON",
"state": "AL",
"postal_code": "35646",
"telephone_number": "970-417-7462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4580 TOWNE LAKE PKWY",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301895521",
"telephone_number": "678-771-6459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "DAVIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-23",
"last_updated": "2023-05-23",
"certification_date": "2023-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AL",
"license": "489346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.