Active NPI
Craig Martin, M.D.
- Psychiatry Physician
- Mansfield Center, CT
National Provider Identifier
1063570646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 41480
- Practice address
- 189 Storrs Rd
Mansfield Center, CT 06250-1683 - Phone
- (860) 456-1311
- Fax
- (860) 450-0165
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 41480 | CT | Primary |
Addresses
Primary practice location
189 Storrs Rd
Mansfield Center, CT 06250-1683
Mailing address
Tyler Avenue
Groton, CT 06340
Phone (860) 208-9163
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82956 | SC | MD | Family Medicine Physician |
| 41480 | CT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Natchaug Hospital, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatric Hospital
- Mansfield Center, CT
- NPI 1295811321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063570646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "TYLER AVENUE",
"city": "GROTON",
"state": "CT",
"postal_code": "06340",
"telephone_number": "860-208-9163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "189 STORRS RD",
"city": "MANSFIELD CENTER",
"state": "CT",
"postal_code": "062501683",
"telephone_number": "860-456-1311",
"fax_number": "860-450-0165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "CRAIG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "41480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield Center, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.