NPIMap

Organization Active NPI

C H Martin Company

  • Prosthetic/Orthotic Supplier
  • Suwanee, GA
National Provider Identifier
1790814853
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
C H MARTIN COMPANY
Practice address
345 Peachtree Industrial Blvd Suite 1202
Suwanee, GA 30024
Phone
(770) 271-7540
Fax
(770) 271-5553
NPI assigned
Mar 5, 2007
Last updated
Mar 7, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
C H MARTIN COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Authorized official

Name
Ms. Doris Wilkes
Title
Authorized Official
Phone
(478) 224-1061

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

345 Peachtree Industrial Blvd Suite 1202
Suwanee, GA 30024

Mailing address

329 Marietta St NW
Atlanta, GA 30313-1600
Phone (404) 525-1533

Other identifiers 2

IdentifierTypeStateIssuer
00039531BMedicaidGA
00039531AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930017948 GA DME Supplier - Orthotic PersonnelDME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Medical Supply Company With Prosthetic PersonnelDME Supplier - Prosthetic Personnel 0648397075 Practice locations: Suwanee, GA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
C H Martin Company2 organizations share this tax ID, including this one
Part of
C H Martin Company

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

197 14th St NW
Ste 150
Atlanta, GA 30318

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488844800000",
    "number": "1790814853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 MARIETTA ST NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303131600",
            "telephone_number": "404-525-1533",
            "fax_number": "404-525-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 PEACHTREE INDUSTRIAL BLVD SUITE 1202",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "30024",
            "telephone_number": "770-271-7540",
            "fax_number": "770-271-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C H MARTIN COMPANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "C H MARTIN COMPANY",
        "enumeration_date": "2007-03-05",
        "last_updated": "2017-03-07",
        "status": "A",
        "authorized_official_last_name": "WILKES",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "478-224-1061",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00039531B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00039531A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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.