Martin Health

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MARTIN HEALTH

Doing business as

West Tennessee Medical Group Primary Care Martin

Practice address

143 Kennedy Drive
Martin, TN 38237-3309

Phone

(731) 587-5321

Fax

(731) 588-3229

NPI assigned

Mar 15, 2017

Last updated

Oct 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bartley Teague

Title

Executive Director

Phone

(731) 512-1277

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• West Tennessee Medical Group Primary Care Martin Doing business as

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871034462. Details of each certification follow.

• CCN 443452 Rural health clinic · Active · Details

Rural health clinic certification: CCN 443452

Legal name

MARTIN HEALTH

Doing business as

WEST TENNESSEE MEDICAL GROUP PRIMARY CARE MARTIN

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Aug 14, 2017

Last certification

Aug 14, 2017

Ownership / control type

1B

Most recent change of ownership

Jun 1, 2018 (1 total)

Organization structure

CorporationNon-profit

Enrollment address

143 Kennedy Dr
Martin, TN 38237-3309

Related CCNs

440061

Related certifications (CCN) 1

Facilities connected through Provider of Services related, parent or unit certification numbers.

• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372

  Parent provider

  Provider of Services

Other NPIs with the same Medicare PAC ID 3

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

• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372

  5193070613

  Same PAC ID
• Martin Health

  dba West Tennessee Medical Group Hillview South Clinic

  • Rural Health Clinic/Center
  • South Fulton, TN
  • NPI 1669876520

  5193070613

  Same PAC ID
• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Martin, TN
  • NPI 1821060930

  5193070613

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Martin Health

  dba West Tennessee Medical Group Hillview South Clinic

  • Rural Health Clinic/Center
  • South Fulton, TN
  • NPI 1669876520

  O20180925003822

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Martin Health5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital Pharmacy

  • Pharmacy
  • Martin, TN
  • NPI 1093582496
  NPD tax ID
• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372
  NPD tax ID
• Martin Health

  dba West Tennessee Medical Group Hillview South Clinic

  • Rural Health Clinic/Center
  • South Fulton, TN
  • NPI 1669876520
  NPD tax ID
• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Martin, TN
  • NPI 1821060930
  NPD tax ID

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Martin Health

  dba West Tennessee Medical Group Hillview South Clinic

  • Rural Health Clinic/Center
  • South Fulton, TN
  • NPI 1669876520

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Martin, TN
  • NPI 1821060930

  5% Or Greater Direct Ownership Interest

  CMS ownership

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Martin Health

  dba West Tennessee Medical Group Hillview South Clinic

  • Rural Health Clinic/Center
  • South Fulton, TN
  • NPI 1669876520

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Martin, TN
  • NPI 1821060930

  5% Or Greater Direct Ownership Interest

  CMS ownership

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372

  Martin Health

  CMS ownership
• Martin Health

  dba West Tennessee Medical Group Hillview South Clinic

  • Rural Health Clinic/Center
  • South Fulton, TN
  • NPI 1669876520

  Martin Health

  CMS ownership
• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Martin, TN
  • NPI 1821060930

  Martin Health

  CMS ownership

Practitioners 12

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.

• Michael Lee Bryant, MD

  • Family Medicine Physician
  • McKenzie, TN
  • NPI 1154324960
  NPD
• Fred Gregory Cox, MD

  • Internal Medicine Physician
  • South Fulton, TN
  • NPI 1104830801
  NPD
• Hunter J Crouse, DO

  • Family Medicine Physician
  • Martin, TN
  • NPI 1083363840
  NPD
• Elizabeth R Frazier, APRN

  • Nurse Practitioner
  • South Fulton, TN
  • NPI 1699789305
  NPD
• Kathryn J Glass, MD

  • Family Medicine Physician
  • Martin, TN
  • NPI 1679527923
  NPD
• Gregory Erwin Mitchell, MD

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1871596973
  NPD
• Amiee Foley Stooksberry, APRN

  • Nurse Practitioner
  • Martin, TN
  • NPI 1992919096
  NPD
• Grant Kneeland Studebaker, MD

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1265774236
  NPD
• Kimberly A Tilghman-Burch, MD

  • Pediatrics Physician
  • South Fulton, TN
  • NPI 1972585065
  NPD
• Justin Turner

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1235670647
  NPD
• Joshua Drew Whitledge, DO

  • Family Medicine Physician
  • South Fulton, TN
  • NPI 1871596767
  NPD
• Melissa Yvette Turner, FNP-C

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1467819748
  NPD

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1871034462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 KENNEDY DRIVE",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382373309",
            "telephone_number": "731-587-5321",
            "fax_number": "731-588-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 KENNEDY DRIVE",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382373309",
            "telephone_number": "731-587-5321",
            "fax_number": "731-588-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-15",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "BARTLEY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "731-512-1277"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TN",
            "license": "0000000126",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B PTAN",
            "identifier": "0757",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044-3452",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Tennessee Medical Group Primary Care Martin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Martin Clinic Corp
• Martin Clinic Corp (Rural Health Associates of NW TN)
• Martin Health (West Tennessee Healthcare Volunteer Hospital Pharmacy)
• Martin Health (West Tennessee Healthcare Volunteer Hospital)
• Martin Health (West Tennessee Healthcare Volunteer Hospital)
• Martin Hospital Company LLC
• Martin Hospital Corporation (Volunteer Community Hospital Pathology)
• Martin Medical Center, P.C.
• Martin Medical Center, P.C.
• Martin Mini Implant Associates, LLC

• Rural Health Clinic/Center in Martin, TN
• Providers in Martin, TN by specialty
• Rural Health Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.