NPIMap

Individual provider Active NPI

Andy M Martin, CRNA

  • Certified Registered Nurse Anesthetist
  • Waycross, GA
National Provider Identifier
1730412990
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN205128 Issued in GA
Practice address
410 Darling Ave
Dept of Anesthesia
Waycross, GA 31501-5246
Phone
(912) 338-6511
Fax
(912) 338-6512
NPI assigned
Sep 4, 2009
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 20767 SC
Certified Registered Nurse Anesthetist 367500000X RN205128 GA Primary

Addresses

Primary practice location

410 Darling Ave
Dept of Anesthesia
Waycross, GA 31501-5246

Mailing address

595 W Carolina Ave
Varnville, SC 29944-4735
Phone (912) 338-6511

Other practice location 1

1000 Medical Center Dr
Hardeeville, SC 29927-3446
Phone (843) 784-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170510000506 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9830236991 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians
Hampton Regional Medical CenterGroup PAC ID 0941107296, 12 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Dr
Hardeeville, SC 29927-3446
Phone (843) 784-8000

595 W Carolina Ave
Varnville, SC 29944-4735
Phone (803) 943-2771

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN205128GAMDCertified Registered Nurse Anesthetist
20767SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Cheraw CurrentSince Mar 2, 2019 Accepting new patients
McLeod Health Clarendon CurrentSince Aug 13, 2017 Accepting new patients
Cep America - Anesthesia PC CurrentSince Feb 1, 2025 Accepting new patients
McLeod Medical Center-Dillon CurrentSince Feb 10, 2018 Accepting new patients
McLeod Health Cheraw Nurse Anesthetist, Certified Registered CurrentSince Mar 2, 2019 Accepting new patients
McLeod Health Clarendon CurrentSince Aug 13, 2017 Accepting new patients
Hampton Regional Medical Center CurrentSince Apr 10, 2017 Accepting new patients
McLeod Health Clarendon Nurse Anesthetist, Certified Registered Current Accepting new patients
Cep America - Anesthesia PC CurrentSince Feb 1, 2025 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 8, 2022 Accepting new patients
McLeod Medical Center-Dillon Nurse Anesthetist, Certified Registered CurrentSince Feb 10, 2018 Accepting new patients
Hampton Regional Medical Center CurrentSince Apr 10, 2017 Accepting new patients
Kentucky Anesthesia Group, PSC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

301 E Jackson St
Dillon, SC 29536
Phone (843) 774-1166

1000 Medical Center Dr
Hardeeville, SC 29927
Phone (843) 784-8138

25 Hospital Ctr
Hilton Head Island, SC 29926
Phone (843) 682-2345

10 E Hospital St
Manning, SC 29102
Phone (803) 433-3000

3545 Highway 17
Ste 100
Murrells Inlet, SC 29576
Phone (843) 299-1717

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

595 W Carolina Ave
Varnville, SC 29944
Phone (803) 943-1221

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1730412990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 W CAROLINA AVE",
            "city": "VARNVILLE",
            "state": "SC",
            "postal_code": "299444735",
            "telephone_number": "912-338-6511",
            "fax_number": "912-338-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 DARLING AVE",
            "address_2": "DEPT OF ANESTHESIA",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015246",
            "telephone_number": "912-338-6511",
            "fax_number": "912-338-6512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Hardeeville",
            "state": "SC",
            "postal_code": "299273446",
            "country_code": "US",
            "telephone_number": "843-784-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ANDY",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-04",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "20767",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN205128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.