Individual provider Active NPI

Judy Martin, CNM

  • Advanced Practice Midwife
  • Dalton, GA
National Provider Identifier
1861538068
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
R074693 Issued in GA
Practice address
1105 Burleyson Rd
Dalton, GA 30720-3017
Phone
(706) 278-4640
Fax
(706) 275-6599
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X R074693 GA Primary

Addresses

Primary practice location

1105 Burleyson Rd
Dalton, GA 30720-3017

Mailing address

1105 Burleyson Rd
Dalton, GA 30720-3017
Phone (706) 278-4640

Other identifiers 1

IdentifierTypeStateIssuer
00417414BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
R074693GAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Obstetrics & Gynecology, PC PastSince Jul 21, 1997 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: judy.martin.1@4044.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/4044/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1861538068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 BURLEYSON RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203017",
            "telephone_number": "706-278-4640",
            "fax_number": "706-275-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 BURLEYSON RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203017",
            "telephone_number": "706-278-4640",
            "fax_number": "706-275-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JUDY",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "R074693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00417414B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.