David Christopher Martin, DO
Individual provider Active NPI Family Medicine Physician · MC Kenzie, TN
NPI 1902809718 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1902809718
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- DO1376 (TN)
- Practice address
- 205 Hospital Dr Ste a
MC Kenzie, TN 38201-1649 - Phone
- (731) 352-7907
- Fax
- (731) 352-4459
- NPI assigned
- May 24, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Northwestern University Feinberg Medical School, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1314 University Ave
Sewanee, TN 37375-2336
Phone (931) 598-5648
PO Box
Suite 700
Sewanee, TN 37375-0700
Hospital & facility affiliations
- Amedisys Home Care
- Homefirst Home Healthcare
- Adoration Home Health and Hospice Care East TN
- Hospice of Chattanooga Holdings, LLC
- Southern Tennessee Regional Health System Winchest
- NHC Healthcare, Sequatchie
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041102000669 | TN | Practitioner - Family Practice |
6800858739 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO1376 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sewanee Family Practice PLLC | Family Medicine | Current |
Accepting new patients |
| NHC Healthcare-Sequatchie LLC | Past | Accepting new patients | |
| Shiloh Emergency Physicians LLC | Past | Accepting new patients |
Locations
1314 University Ave
Sewanee, TN 37375
Phone (931) 598-5648
Interoperability endpoints
- david.martin.1@1292.direct.athenahealth.com
- https://api.platform.athenahealth.com/1292/brand/1/csg/41/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO1376 | TN | Yes |
Addresses
Primary practice location
205 Hospital Dr Ste a
MC Kenzie, TN 38201-1649
Mailing address
PO Box 700
Sewanee, TN 37375-0700
Phone (931) 598-5648
Other practice location 1
1314 University Ave
Sewanee, TN 37375-2336
Phone (931) 598-5648
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477516953 | Other | TN | GROUP NPI |
| 3306765 | Medicaid | TN | |
| 1063817625 | Other | TN | GROUP NPI |
| DO1376 | Other | TN | MEDICAL LICENSE |
Other providers in MC Kenzie, TN
- Cynthia H Laux
- William Clark Lemons
- Sarah Leyerle
- Amber Nicole Lipford
- LS Transportation
- McKenzie Board of Education
- McKenzie Clinic Corp
- McKenzie Family Chiropractic
- McKenzie Healthcare and Rehabilitation Center LLC
- McKenzie Medical Center
All providers in MC Kenzie, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.