Individual provider Active NPI

Justin C Martin, OTR

  • Occupational Therapist
  • Nashville, TN
National Provider Identifier
1124450812
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3657 Issued in TN
Practice address
4206 Stammer PL
Nashville, TN 37215-3302
Phone
(615) 298-4555
Fax
(615) 298-4555
NPI assigned
Aug 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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 3657 TN Primary

Addresses

Primary practice location

4206 Stammer PL
Nashville, TN 37215-3302

Mailing address

2222 Sullivan TRL
Easton, PA 18040-7958
Phone (800) 944-9782

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3657TNMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1124450812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SULLIVAN TRL",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180407958",
            "telephone_number": "800-944-9782",
            "fax_number": "610-438-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4206 STAMMER PL",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372153302",
            "telephone_number": "615-298-4555",
            "fax_number": "615-298-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JUSTIN",
        "middle_name": "C",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-05",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "3657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.