Active NPI
Heather Marie Martyn, BCBA
- Behavior Analyst
- Brookfield, WI
National Provider Identifier
1073006334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 234-140
- Practice address
- 150 N Sunny Slope Rd Ste 100
Brookfield, WI 53005-4806 - Phone
- (262) 432-5660
- Fax
- (262) 432-5666
- NPI assigned
- Jun 12, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 234-140 | WI | Primary |
Addresses
Primary practice location
150 N Sunny Slope Rd Ste 100
Brookfield, WI 53005-4806
Mailing address
1210 Fourier Dr Ste 100
Madison, WI 53717-1969
Phone (608) 662-9327
Other names 1
- Heather Marie Drury
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 234-140 | WI | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Autism Spectrum Therapies of Delaware, LLC | Behavior Analyst | 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.
-
- Clinical Psychologist
- Madison, WI
- NPI 1043406978
Behavior Analyst
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635120000000",
"number": "1073006334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 FOURIER DR STE 100",
"city": "MADISON",
"state": "WI",
"postal_code": "537171969",
"telephone_number": "608-662-9327",
"fax_number": "608-662-9041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 N SUNNY SLOPE RD STE 100",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530054806",
"telephone_number": "262-432-5660",
"fax_number": "262-432-5666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTYN",
"first_name": "HEATHER",
"middle_name": "MARIE",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-12",
"last_updated": "2021-10-25",
"certification_date": "2021-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WI",
"license": "234-140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HEATHER",
"last_name": "DRURY",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.