MR. JERRY WAYNE MARTIN II LPC
NPI 1831149640
Counselor - Professional in Summerville, SC

Q: What is Jerry Martin's NPI number?

The NPI number for Jerry Martin is 1831149640. It was assigned to this individual provider in the NPPES registry on May 11, 2006.

Q: What is Jerry Martin's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: Is Jerry Martin enrolled in Medicare?

No. Jerry Martin has opted out of Medicare through September 5, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Jerry Martin was last updated on March 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 11, 2006Opted out of Medicare · through Sep 5, 2026

709 OLD TROLLEY RD, SUMMERVILLE, SC 29485(843) 900-6767(843) 285-5916 Get Directions Write a Review

NPPES record last updated: March 15, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Mr. Jerry Wayne Martin Ii Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JERRY WAYNE MARTIN II LPC (NPI 1831149640) is an individual professional provider in Summerville, South Carolina, licensed in South Carolina (3929) and active in the NPI registry since May 2006. He has opted out of Medicare through September 5, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1831149640

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMR. JERRY WAYNE MARTIN IICredential: LPC

Location Address709 OLD TROLLEY RDSummerville, SC 29485-5203

Mailing Address709 Old Trolley RdSummerville, SC 29485-5203 · (843) 900-6767 · Fax (843) 285-5916

Phone(843) 900-6767

Fax(843) 285-5916

Sole ProprietorYes

Enumeration DateMay 11, 2006

Last NPPES UpdateMarch 15, 2024

✔ NPI 1831149640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in SC · 3929

709 OLD TROLLEY RD, Summerville, SC 29485

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mr. Jerry Wayne Martin Ii Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 5, 2024 through September 5, 2026.

Opt-Out Effective DateSeptember 5, 2024

Opt-Out In Effect ThroughSeptember 5, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIAN D MUSOLF LPC

Counselor (Professional)