Individual provider Active NPI

Mysonya Earlisa Martin, NP

  • Family Nurse Practitioner
  • Bowman, GA
National Provider Identifier
1891474300
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP160091 Issued in GA
Practice address
206 E Church St
Bowman, GA 30624-2109
Phone
(706) 245-7361
NPI assigned
Jul 12, 2023
Last updated
Oct 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-NP160091 GA Primary

Addresses

Primary practice location

206 E Church St
Bowman, GA 30624-2109

Mailing address

206 E Church St
Bowman, GA 30624-2109
Phone (706) 245-7361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230721001419 GA Practitioner - Nurse Practitioner 0749640779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medlink Georgia IncGroup PAC ID 3274442850, 93 clinicians

Practice addresses (Care Compare)

206 E Church St
Bowman, GA 30624-2109
Phone (706) 245-7361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-NP160091GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medlink Georgia Inc CurrentSince Jul 11, 2023 Accepting new patients
Medlink Georgia, Inc CurrentSince Jul 11, 2023 Accepting new patients

Locations

206 E Church St
Bowman, GA 30624
Phone (706) 245-7361

11 Charlie Morris Rd
Bldg 2
Colbert, GA 30628
Phone (706) 738-3234

Interoperability endpoints

  • Direct secure messaging: mysonya.martin.1@9864.direct.athenahealth.com
  • Direct secure messaging: mysonya.martin@mgi.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1891474300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 E CHURCH ST",
            "city": "BOWMAN",
            "state": "GA",
            "postal_code": "306242109",
            "telephone_number": "706-245-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 E CHURCH ST",
            "city": "BOWMAN",
            "state": "GA",
            "postal_code": "306242109",
            "telephone_number": "706-245-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MYSONYA",
        "middle_name": "EARLISA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP160091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowman, GA

Sources for this page

Verify at the official NPI Registry.