Individual provider Active NPI

Adam James Martin

  • Surgical Physician Assistant
  • Kettering, OH
National Provider Identifier
1932943164
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.009178RX Issued in OH
Practice address
3533 Southern Blvd Ste 2100
Kettering, OH 45429-1267
Phone
(937) 395-8556
Fax
(937) 395-6376
NPI assigned
Jun 21, 2024
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50.009178RX OH Primary

Addresses

Primary practice location

3533 Southern Blvd Ste 2100
Kettering, OH 45429-1267

Mailing address

969 Wilmington Ave Apt C
Dayton, OH 45420-1655
Phone (304) 610-8633

Other practice location 1

272 Hospital Rd
Chillicothe, OH 45601-9031
Phone (304) 610-8633

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/
Direct Messaging Address amartin890447@direct.ketteringhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241231003132 OH Practitioner - Physician Assistant 0042747123 Reassigns benefits to 1 organization
I20260420000050 VA Practitioner - Physician Assistant 0042747123 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

220 Campus Blvd
Suite 100
Winchester, VA 22601-2896

220 Campus Blvd
Suite 320
Winchester, VA 22601-2888

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Radiologists PC CurrentSince Apr 1, 2026 Accepting new patients

Locations

351 Valley Health Way
Front Royal, VA 22630
Phone (540) 636-0300

200 Memorial Dr
Luray, VA 22835
Phone (540) 743-4561

160 Exeter Dr
Ste 103
Winchester, VA 22603
Phone (541) 686-1600

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100

Interoperability endpoints

  • Direct secure messaging: amartin890447@direct.ketteringhealth.org

Organizations & group practices 5

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": "1718928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1932943164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 WILMINGTON AVE APT C",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454201655",
            "telephone_number": "304-610-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 SOUTHERN BLVD STE 2100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291267",
            "telephone_number": "937-395-8556",
            "fax_number": "937-395-6376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "272 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456019031",
            "country_code": "US",
            "telephone_number": "304-610-8633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ADAM",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-21",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.009178RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "3533 Southern Blvd Ste 2100",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291267",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amartin890447@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3533 Southern Blvd Ste 2100",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.