Active NPI
Bess J. Martin, PHD, LP
- Clinical Neuropsychologist
- Fargo, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 613
- Practice address
- 1702 University Dr S
Fargo, ND 58103-4940 - Phone
- (701) 364-3300
- Fax
- (701) 364-8906
- NPI assigned
- Jun 18, 2007
- Last updated
- Nov 17, 2021
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 94022385 | CA | |
| Clinical Neuropsychologist | 103G00000X | 613 | ND | Primary |
| Clinical Psychologist | 103TC0700X | LP6706 | MN | |
| Case Manager/Care Coordinator | 171M00000X | NU |
Addresses
Primary practice location
1702 University Dr S
Fargo, ND 58103-4940
Mailing address
1702 University Dr S
Fargo, ND 58103-4940
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- St Marys Regional Health Center
Practice addresses (Care Compare)
1702 University Dr S
Fargo, ND 58103-4940
Phone (701) 364-8900
705 Pleasant Ave S
Park Rapids, MN 56470-1440
Phone (218) 732-2800
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94022385 | CA | MD | Mental Health Counselor |
| LP6706 | MN | MD | Clinical Psychologist |
| 613 | ND | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovis Health LLC | Current | Accepting new patients | |
| Innovis Health, LLC | Current | Accepting new patients | |
| St. Mary's Regional Health Center | Current | Accepting new patients | |
| St. Marys Regional Health Center | Current | Accepting new patients | |
| Innovis Health LLC | Current | Accepting new patients | |
| St Mary's Regional Health Center | Current | Accepting new patients |
Locations
1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300
1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222
3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000
Organizations & group practices 6
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.
-
dba Essentia Health St. Mary's- Detroit Lakes
- Rural Acute Care Hospital
- Detroit Lakes, MN
- NPI 1679561088
-
dba Essentia Health-Osgood Clinic
- Multi-Specialty Clinic/Center
- Fargo, ND
- NPI 1144776576
-
dba Essentia Health 52nd Avenue Clinic
- Multi-Specialty Clinic/Center
- Fargo, ND
- NPI 1780043257
-
dba Essentia Health St. Mary's-Frazee Clinic
- Rural Health Clinic/Center
- Frazee, MN
- NPI 1902364482
-
dba Essentia Health St. Mary's - Frazee Clinic
- Family Medicine Physician
- Frazee, MN
- NPI 1275977928
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": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637107200000",
"number": "1043415318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1702 UNIVERSITY DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581034940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 UNIVERSITY DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581034940",
"telephone_number": "701-364-3300",
"fax_number": "701-364-8906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "BESS",
"middle_name": "J.",
"credential": "PHD, LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-18",
"last_updated": "2021-11-17",
"certification_date": "2021-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "94022385",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "ND",
"license": "613",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP6706",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.