Gary Robert Martin

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

License

CHF-2918 Issued in ID

Practice address

516 Laurel Lane
Naples, ID 83847

Phone

(208) 610-1686

NPI assigned

Dec 30, 2022

Last updated

Feb 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1672358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1073226437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 LAURAL LN",
            "city": "NAPLES",
            "state": "ID",
            "postal_code": "838475190",
            "telephone_number": "208-610-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 LAUREL LANE",
            "city": "NAPLES",
            "state": "ID",
            "postal_code": "83847",
            "telephone_number": "208-610-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "GARY",
        "middle_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-30",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ID",
            "license": "CHF-2918",
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "ID",
            "license": "CHF-2918",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IDTPID006303",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jcgsas777@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "516 Laural Ln",
            "city": "Naples",
            "state": "ID",
            "country_code": "US",
            "postal_code": "83847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "whatever",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "516 Laurel lane",
            "city": "Naples",
            "state": "ID",
            "country_code": "US",
            "postal_code": "83847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tracy Davidson
• Emilie Moreau, LCPC
• Rhonda Perry
• Jared Sartell
• Megan Saxon-Labelle, M.S.
• Tracy Irene Davidson

• Foster Care Agency in Naples, ID
• Providers in Naples, ID by specialty
• Foster Care Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.