Individual provider Active NPI

Gregory Warren Martin, LMP

  • Massage Therapist
  • Tacoma, WA
National Provider Identifier
1114288875
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
601989028 Issued in WA
Practice address
4115 6TH Ave
Tacoma, WA 98406
Phone
(253) 752-5052
Fax
(253) 752-5052
NPI assigned
May 30, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 601989028 WA Primary

Addresses

Primary practice location

4115 6TH Ave
Tacoma, WA 98406

Mailing address

4115 6TH Ave
Tacoma, WA 98406
Phone (253) 752-5052

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

LicenseStateTypeSpecialty
601989028WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1114288875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 6TH AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98406",
            "telephone_number": "253-752-5052",
            "fax_number": "253-752-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 6TH AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98406",
            "telephone_number": "253-752-5052",
            "fax_number": "253-752-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "GREGORY",
        "middle_name": "WARREN",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-30",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "601989028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; 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.