Individual provider Active NPI

Justin K Martin, OT

  • Occupational Therapist
  • Jonesboro, AR
National Provider Identifier
1093283798
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR3214 Issued in AR
Practice address
4800 E Johnson Ave
Jonesboro, AR 72401-8413
Phone
(870) 936-8000
Fax
(870) 936-0141
NPI assigned
Nov 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTR3214 AR Primary

Addresses

Primary practice location

4800 E Johnson Ave
Jonesboro, AR 72401-8413

Mailing address

PO Box 1960
Jonesboro, AR 72403-1960
Phone (870) 936-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181210003151 AR Practitioner - Occupational Therapist in Private Practice 2466796917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 Windover Rd
Jonesboro, AR 72401-6159
Phone (870) 935-5432

4700 W Kingshighway
Paragould, AR 72450-3465
Phone (870) 240-8402

Merit-based Incentive Payment System (MIPS)

Final score
75.65 of 100Reported as group
Quality
44.87
Promoting interoperability
100
Improvement activities
40
Cost
73.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTR3214ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Arkansas Clinic Charitable Foundation, Inc. CurrentSince Nov 5, 2018 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. CurrentSince Nov 5, 2018 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Current Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Past Accepting new patients

Locations

1111 Windover Rd
Jonesboro, AR 72401
Phone (870) 935-5432

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

4700 W Kingshighway
Paragould, AR 72450
Phone (870) 240-8402

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1093283798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1960",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031960",
            "telephone_number": "870-936-8000",
            "fax_number": "870-936-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 E JOHNSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724018413",
            "telephone_number": "870-936-8000",
            "fax_number": "870-936-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JUSTIN",
        "middle_name": "K",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-12",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR3214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.