Individual provider Active NPI

Eva Dickinson Martin, DPT

  • Physical Therapist
  • Augusta, GA
National Provider Identifier
1790108041
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011301 Issued in GA
Practice address
106 Pleasant Home Rd Ste 2K
Augusta, GA 30907-0510
Phone
(707) 724-6543
Fax
(206) 350-9023
NPI assigned
Jan 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT011301 GA Primary

Addresses

Primary practice location

106 Pleasant Home Rd Ste 2K
Augusta, GA 30907-0510

Mailing address

3669 Foxfire PL Ste 250
Augusta, GA 30907-7902
Phone (706) 360-4234

Other practice location 1

2258 Wrightsboro Rd
Suite 250
Augusta, GA 30904-4887
Phone (706) 724-6543

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240807001288 IL Practitioner - Physical Therapist in Private Practice 3779716402 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reinvent Health Inc.Group PAC ID 2264964477, 38 clinicians

Practice addresses (Care Compare)

Chicago, IL 60622
Phone (405) 821-6648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reinvent Health Inc Physical Therapist CurrentSince Dec 6, 2024 Accepting new patients
Synergy Care Southeast, LLC Physical Therapist CurrentSince Apr 20, 2024 Accepting new patients

Locations

117 N Western Ave
Peoria, IL 61604
Phone (309) 674-2400

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": "1390348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1790108041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3669 FOXFIRE PL STE 250",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309077902",
            "telephone_number": "706-360-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 PLEASANT HOME RD STE 2K",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309070510",
            "telephone_number": "707-724-6543",
            "fax_number": "206-350-9023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2258 Wrightsboro Rd",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309044887",
            "country_code": "US",
            "telephone_number": "706-724-6543",
            "fax_number": "206-350-9023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "EVA",
        "middle_name": "DICKINSON",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-22",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.