Active NPI
Jessie Nicole Martin, DO
- Internal Medicine Physician
- Gulfport, MS
National Provider Identifier
1952861197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 30137
- Practice address
- 4500 13TH Street
Gulfport, MS 39501 - Phone
- (228) 867-4396
- Fax
- (228) 867-5354
- NPI assigned
- Mar 22, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 30137 | MS | |
| Internal Medicine Physician | 207R00000X | 30137 | MS | Primary |
Addresses
Primary practice location
4500 13TH Street
Gulfport, MS 39501
Mailing address
PO Box 1810
Gulfport, MS 39502
Phone (228) 575-1194
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Philadelphia College of Osteopathic Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-4499
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30137 | MS | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital at Gulfport | Internal Medicine | Current | Accepting new patients |
| Memorial Hospital at Gulfport | Current | Accepting new patients | |
| Memorial Hospital at Gulfport | Current | Accepting new patients | |
| Biloxi Hma LLC | Past | Accepting new patients |
Locations
1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856
4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872
Interoperability endpoints
- jessie.martin@direct.mhg.com
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 and National Provider Directory roles.
-
- Urology Physician
- Gulfport, MS
- NPI 1093142598
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1215546635
-
- Emergency Medicine Physician
- Gulfport, MS
- NPI 1962780379
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1972557064
Hospital & facility affiliations 60
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Gulfport, MS
- NPI 1184956815
Hospital
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1215546635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695772800000",
"number": "1952861197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1810",
"city": "GULFPORT",
"state": "MS",
"postal_code": "39502",
"telephone_number": "228-575-1194",
"fax_number": "228-575-2917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 13TH STREET",
"city": "GULFPORT",
"state": "MS",
"postal_code": "39501",
"telephone_number": "228-867-4396",
"fax_number": "228-867-5354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JESSIE",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-22",
"last_updated": "2023-09-27",
"certification_date": "2023-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MS",
"license": "30137",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MS",
"license": "30137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.