NPIMap

Individual provider Active NPI

Susan S Lowry, MD

  • Family Medicine Physician
  • Martin, TN
National Provider Identifier
1871592287
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD26758 Issued in TN
Practice address
117 Kennedy Dr
Martin, TN 38237-3394
Phone
(731) 587-9511
Fax
(877) 309-6416
NPI assigned
Jul 18, 2005
Last updated
May 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD26758 TN Primary

Addresses

Primary practice location

117 Kennedy Dr
Martin, TN 38237-3394

Mailing address

117 Kennedy Dr
Martin, TN 38237-3309
Phone (731) 587-9511

Other identifiers 4

IdentifierTypeStateIssuer
3091111MedicaidTN
2646506OtherAMERIGROUP
5281135OtherAETNA
3028491OtherTNBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address martinmedicalctr@353.direct.myezyaccess.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050108000091 TN Practitioner - Family Practice 2264480458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
East Tennessee State University Quillen College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin Medical Center PCGroup PAC ID 9436127008, 7 clinicians

Practice addresses (Care Compare)

117 Kennedy Dr
Martin, TN 38237-3309
Phone (731) 587-9511

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD26758TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Medical Center, P.C. CurrentSince Jun 10, 1995 Accepting new patients
Martin Medical Center, P.C. Family Medicine Current Accepting new patients
Cane Creek Healthcare, Inc. Past Accepting new patients
Martin Health Past Accepting new patients
CLC of Dresden, LLC Past Accepting new patients
Weakley County Nursing Home Past Accepting new patients
Weakley Healthcare, LLC Past Accepting new patients
Diversicare Leasing LP Past Accepting new patients
Vanayer Healthcare and Rehab Center LLC Past Accepting new patients

Locations

117 Kennedy Dr
Martin, TN 38237
Phone (731) 587-9511

Ownership & related parties

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Hillview Community Living CenterDresden, TN, CCN 445367 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 1, 2007
Sep 1, 2007
Diversicare of MartinMartin, TN, CCN 445249 Skilled nursing facility Contracted Managing Employee
Adp of the SNF		 Jun 1, 2016
Nov 25, 2024
Weakley Rehabilitation and Nursing CenterDresden, TN, CCN 445437 Skilled nursing facility Operational/Managerial Control
Managing Control - Governing Body
Adp of the SNF		 Dec 1, 2024
Dec 1, 2024
Dec 1, 2024
Beacon HospiceMC Kenzie, TN, CCN 441581 Hospice Contracted Managing Employee Oct 1, 2010
Martin Medical Center PCMartin, TN, CCN 448990 Rural health clinic 5% Or Greater Direct Ownership Interest (33.3%)
Corporate Officer		 Aug 1, 2017
Aug 1, 2017

Owned or controlled facilities with NPI records 5

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

Organizations & group practices 9

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.

Hospital & facility affiliations 11

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1871592287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 KENNEDY DR",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382373309",
            "telephone_number": "731-587-9511",
            "fax_number": "877-309-6416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 KENNEDY DR",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382373394",
            "telephone_number": "731-587-9511",
            "fax_number": "877-309-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWRY",
        "first_name": "SUSAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD26758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3091111",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "2646506",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5281135",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3028491",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "martinmedicalctr@353.direct.myezyaccess.com",
            "affiliation": "N",
            "address_1": "117 Kennedy Dr",
            "city": "Martin",
            "state": "TN",
            "country_code": "US",
            "postal_code": "382373309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Martin, TN

Sources for this page

Verify at the official NPI Registry.