Active NPI
Thomas Martin, PT
- Physical Therapist
- Grand Canyon, AZ
National Provider Identifier
1013981133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3678
- Practice address
- 1 Clinic Road
Grand Canyon, AZ 86023 - Phone
- (928) 638-2551
- Fax
- (928) 638-2598
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3678 | AZ | Primary |
Addresses
Primary practice location
1 Clinic Road
Grand Canyon, AZ 86023
Mailing address
PO Box 3630
Flagstaff, AZ 86003-3630
Phone (928) 233-5110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3678 | Other | AZ | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3678 | AZ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274918400000",
"number": "1013981133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3630",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860033630",
"telephone_number": "928-233-5110",
"fax_number": "928-774-6687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CLINIC ROAD",
"city": "GRAND CANYON",
"state": "AZ",
"postal_code": "86023",
"telephone_number": "928-638-2551",
"fax_number": "928-638-2598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "THOMAS",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-15",
"last_updated": "2010-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "3678",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "3678",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Canyon, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.