Individual provider Active NPI

Jon A. Marlton, LMFT

  • Marriage & Family Therapist
  • Cambridge, MN
National Provider Identifier
1104162163
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2076 Issued in MN
Practice address
133 2ND Ave SW
Cambridge, MN 55008-1502
Phone
(763) 689-9407
Fax
(763) 552-0164
NPI assigned
Dec 19, 2012
Last updated
Dec 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2076 MN Primary

Addresses

Primary practice location

133 2ND Ave SW
Cambridge, MN 55008-1502

Mailing address

133 2ND Ave SW
Cambridge, MN 55008-1502
Phone (763) 689-9407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240108005797 MN Practitioner - Marriage and Family Therapist 5294186896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Based Therapy AssociatesGroup PAC ID 2264432681, 12 clinicians

Practice addresses (Care Compare)

237 2ND Ave SW
Suite 117
Cambridge, MN 55008-1500
Phone (763) 689-9407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2076MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Family Based Therapy Associates CurrentSince Jan 1, 2024 Accepting new patients
Family Based Therapy Associates Past Accepting new patients

Locations

133 2nd Ave SW
Cambridge, MN 55008
Phone (763) 689-9407

237 2nd Ave SW
Cambridge, MN 55008
Phone (651) 245-5217

237 2nd Ave SW
Ste 117
Cambridge, MN 55008
Phone (763) 200-3411

199 Coon Rapids Blvd NW
Ste 306
Minneapolis, MN 55433
Phone (763) 780-1520

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1104162163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 2ND AVE SW",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081502",
            "telephone_number": "763-689-9407",
            "fax_number": "763-552-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 2ND AVE SW",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081502",
            "telephone_number": "763-689-9407",
            "fax_number": "763-552-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLTON",
        "first_name": "JON",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-19",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MN

Sources for this page

Verify at the official NPI Registry.