{"npi":"1669876520","type":"NPI-2","status":"active","name":{"display":"Martin Health","other":[],"organization_name":"MARTIN HEALTH","authorised_official":"Tina Prescott"},"specialty":{"primary_taxonomy":"261QR1300X","primary_taxonomy_description":"Rural Health Clinic/Center","slug":"rural-health-clinic-center","schema_org_specialty":null,"all":[{"code":"261QR1300X","description":"Rural Health Clinic/Center","primary":false,"state":"TN","license":"0000000126"},{"code":"261QR1300X","description":"Rural Health Clinic/Center","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"1135 BROADWAY STREET","city":"SOUTH FULTON","state":"TN","postal_code":"382572835","country_code":"US","phone":"7314792606","fax":"7314792610"},{"purpose":"MAILING","street_1":"1135 BROADWAY STREET","city":"SOUTH FULTON","state":"TN","postal_code":"382572835","country_code":"US","phone":"7314792606","fax":"7314792610"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"Q012738","state":"TN","issuer":null},{"type_code":"05","label":"Medicaid","value":"044-3449","state":"TN","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20180725000082","type_code":"00-17","type_desc":"PART A PROVIDER - RURAL HEALTH CLINIC","state":"TN","pac_id":"5193070613"},{"enrlmt_id":"O20180925003822","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"TN","pac_id":"5193070613"}]},"enumeration_date":"2014-10-21","last_updated":"2024-10-14","_meta":{"source":"NPPES","snapshot_date":"2024-10-14","doc_url":"https://findmynpi.com/api"}}