Organization Active NPI

Joseph H. Martin, Jr., MD, LLC

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1700154093
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
025795 Issued in GA
Legal business name
JOSEPH H. MARTIN, JR., MD, LLC
Practice address
550 Peachtree St NE Ste 1420
Atlanta, GA 30308-2241
Phone
(404) 526-9111
Fax
(404) 526-9053
NPI assigned
Dec 1, 2011
Last updated
Dec 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Authorized official

Name
Joseph H Martin Jr., MDNPI 1437264553
Title
Proprietor
Phone
(404) 526-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 025795 GA Primary

Addresses

Primary practice location

550 Peachtree St NE Ste 1420
Atlanta, GA 30308-2241

Mailing address

PO Box 54306
Atlanta, GA 30308-0306
Phone (404) 526-9111

Other identifiers 3

IdentifierTypeStateIssuer
000305698EMedicaidGA
110198450OtherMEDICARE RAILROAD
5225070003OtherGABLUE CROSS BLUE SHIELD OF GA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120404000287 GA Part B Supplier - Clinic/Group Practice 5698935310 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1700154093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54306",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303080306",
            "telephone_number": "404-526-9111",
            "fax_number": "404-526-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE STE 1420",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082241",
            "telephone_number": "404-526-9111",
            "fax_number": "404-526-9053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH H. MARTIN, JR., MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "404-526-9111",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "025795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000305698E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110198450",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF GA",
            "identifier": "5225070003",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.