Mandy Marie Martin, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

ATO336 Issued in MS

Practice address

104 Chrystal Plaza Dr
New Albany, MS 38652-3198

Phone

(662) 534-4445

Fax

(662) 534-9449

NPI assigned

Jul 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Crossroads Rehabilitation Services, Inc

  • Physical Therapy Clinic/Center
  • New Albany, MS
  • NPI 1598851222
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952325284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386520637",
            "telephone_number": "662-296-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CHRYSTAL PLAZA DR",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523198",
            "telephone_number": "662-534-4445",
            "fax_number": "662-534-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MANDY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": "ATO336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reeda Greer Lyons, M.D.
• M Greg Medlin, PLLC (Medlin Chiropractic)
• Mallory's Modern Medicine, LLC
• Quitley Manuel
• Joseph Adam Martin Jr., D.C.
• Bonnie Joyce Mask, CFNP
• Mason Surgical Clinic, PLLC
• Harvey F Mason, MD
• Melanie Murphree Massengill
• Candace Eaton Mauney, FNP

• Athletic Trainer in New Albany, MS
• Providers in New Albany, MS by specialty
• Athletic Trainer in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.