Individual provider Active NPI

Nicholas J. Martin, LPT, PT

  • Physical Therapist
  • Follansbee, WV
National Provider Identifier
1124030168
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
001084 Issued in WV
Practice address
1425 Main St
Follansbee, WV 26037-1217
Phone
(304) 527-4472
Fax
(304) 527-4648
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 001084 WV Primary
Physical Therapist 225100000X PT007091 OH
Physical Therapist 225100000X PT006744L PA

Addresses

Primary practice location

1425 Main St
Follansbee, WV 26037-1217

Mailing address

414 Penco Rd
Weirton, WV 26062
Phone (304) 723-3780

Other practice location 1

1828 Franklin St
Toronto, OH 43964-1949
Phone (740) 337-1366

Other practice location 2

100 Wilhaven Rd Ste 100
Mc Murray, PA 15317-3094
Phone (724) 941-3727

Other identifiers 5

IdentifierTypeStateIssuer
55071930003OtherWVTHE HEALTH PLAN BWC
1515473000OtherWVUS DEPT OF LABOR
55071930000OtherWVWV WORKERS COMP BRICKSTEE
000745333OtherBLUE CROSS/BLUE SHIELD
0156604000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, PA, OH3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20031117000432 WV Practitioner - Physical Therapist in Private Practice 0547174310
I20111216000493 PA Practitioner - Physical Therapist in Private Practice 0547174310
I20240429001510 OH Practitioner - Physical Therapist in Private Practice 0547174310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

414 Penco Rd
Weirton, WV 26062-3822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT007091OHMDPhysical Therapist
PT006744LPAMDPhysical Therapist
001084WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Physical Therapy Limited Partnership Physical Therapist CurrentSince Sep 1, 2022 Accepting new patients
Summit Physical Therapy Limited Partnership Physical Therapist CurrentSince Mar 6, 2024 Accepting new patients

Locations

1828 Franklin St
Toronto, OH 43964
Phone (740) 337-1366

100 Wilhaven Rd
McMurray, PA 15317
Phone (724) 941-3727

118 Carolina Ave
Chester, WV 26034
Phone (304) 387-0409

1425 Main St
Follansbee, WV 26037
Phone (304) 527-4472

47454 Route 52
Kermit, WV 25674
Phone (304) 393-4072

621 N Chester St
New Cumberlnd, WV 26047
Phone (304) 564-1098

414 Penco Rd
Weirton, WV 26062
Phone (304) 723-3780

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1124030168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 PENCO RD",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "26062",
            "telephone_number": "304-723-3780",
            "fax_number": "304-723-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 MAIN ST",
            "city": "FOLLANSBEE",
            "state": "WV",
            "postal_code": "260371217",
            "telephone_number": "304-527-4472",
            "fax_number": "304-527-4648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1828 Franklin St",
            "address_purpose": "LOCATION",
            "city": "Toronto",
            "state": "OH",
            "postal_code": "439641949",
            "country_code": "US",
            "telephone_number": "740-337-1366",
            "fax_number": "740-337-4054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Wilhaven Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Mc Murray",
            "state": "PA",
            "postal_code": "153173094",
            "country_code": "US",
            "telephone_number": "724-941-3727",
            "fax_number": "724-941-3761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "NICHOLAS",
        "middle_name": "J.",
        "credential": "LPT,  PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "001084",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT007091",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT006744L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE HEALTH PLAN BWC",
            "identifier": "55071930003",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "1515473000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV WORKERS COMP BRICKSTEE",
            "identifier": "55071930000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000745333",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0156604000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Follansbee, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.