Individual provider Active NPI

Marta Cheatham-Lott, MD

  • Obstetrics & Gynecology Physician
  • Redlands, CA
National Provider Identifier
1992706451
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A55758 Issued in CA
Practice address
2 W Fern Ave
Redlands, CA 92373-5916
Phone
(909) 793-3311
Fax
(909) 335-9951
NPI assigned
Aug 9, 2005
Last updated
Aug 31, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A55758 CA Primary

Addresses

Primary practice location

2 W Fern Ave
Redlands, CA 92373-5916

Mailing address

PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 793-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060209000457 CA Practitioner - Obstetrics/Gynecology 1153336300 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loma Linda University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15630 18TH Ave
Clearlake, CA 95422-9336
Phone (707) 994-6486

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A55758CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Clearlake Hospital Inc. CurrentSince Jul 1, 2023 Accepting new patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince Apr 1, 2022 Accepting new patients
Beaver Medical Group P C CurrentSince Nov 11, 2012 Accepting new patients
Beaver Medical Group P C Obstetrics & Gynecology CurrentSince Nov 11, 2012 Accepting new patients
Redlands Community Hospital Past Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients
Axminster Medical Group Past Accepting new patients
San Gorgonio Memorial Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Community Alliance Medical Group Inc PastSince Nov 1, 2024 Accepting new patients
Axminster Medical Group Past Accepting new patients
Adventist Health Clearlake Hospital, Inc Past Accepting new patients

Locations

400 Old River Rd
Bakersfield, CA 93311
Phone (661) 663-6000

15230 Lakeshore Dr
Clearlake, CA 95422
Phone (707) 995-4500

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

25500 Medical Center Dr
Murrieta, CA 92562
Phone (951) 696-6000

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

2 W Fern Ave
#1112
Redlands, CA 92373

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

400 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 569-7279

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BJCEDD

Organizations & group practices 12

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1992706451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-793-3311",
            "fax_number": "909-335-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W FERN AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735916",
            "telephone_number": "909-793-3311",
            "fax_number": "909-335-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATHAM-LOTT",
        "first_name": "MARTA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A55758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.