Individual provider Active NPI

Martin D Ball, PA

  • Physician Assistant
  • N Charleston, SC
National Provider Identifier
1912434606
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2807 Issued in SC
Practice address
8091 Rivers Ave
N Charleston, SC 29406-9281
Phone
(843) 572-7000
NPI assigned
May 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2807 SC Primary

Addresses

Primary practice location

8091 Rivers Ave
N Charleston, SC 29406-9281

Mailing address

8091 Rivers Ave
North Charleston, SC 29406-9236
Phone (843) 572-7000

Other practice location 1

730 Stony Landing Rd
Moncks Corner, SC 29461-2904
Phone (843) 899-7700

Other identifiers 1

IdentifierTypeStateIssuer
3579PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20180106000094 SC Practitioner - Physician Assistant 5698034254 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Carenow Urgent Care LLCGroup PAC ID 3274893359, 72 clinicians

Practice addresses (Care Compare)

1115 Savannah Hwy
Charleston, SC 29407-7805
Phone (843) 300-3355

515 Saint James Ave
Goose Creek, SC 29445-2794
Phone (843) 507-8925

8445 Dorchester Rd
North Charleston, SC 29420-7307
Phone (843) 640-5008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2807SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. CurrentSince Sep 1, 2020 Accepting new patients

Locations

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

Interoperability endpoints

  • Direct secure messaging: martin.ball@420883186974724.direct.elationemr.com

Organizations & group practices 3

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": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1912434606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8091 RIVERS AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069236",
            "telephone_number": "843-572-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8091 RIVERS AVE",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294069281",
            "telephone_number": "843-572-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 Stony Landing Rd",
            "address_purpose": "LOCATION",
            "city": "Moncks Corner",
            "state": "SC",
            "postal_code": "294612904",
            "country_code": "US",
            "telephone_number": "843-899-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALL",
        "first_name": "MARTIN",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-12",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3579PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in N Charleston, SC

Sources for this page

Verify at the official NPI Registry.