Individual provider Active NPI

John E. Martin, PSY.D.

  • Clinical Psychologist
  • New Castle, IN
National Provider Identifier
1164665378
Registry record updated Apr 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20041452A Issued in IN
Practice address
320 W Colonial Dr
New Castle, IN 47362-5414
Phone
(765) 465-2902
NPI assigned
Apr 17, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20041452A IN Primary
Forensic Psychologist 103TF0200X 20041452A IN
Intellectual & Developmental Disabilities Psychologist 103TM1800X 20041452A IN

Addresses

Primary practice location

320 W Colonial Dr
New Castle, IN 47362-5414

Mailing address

320 W Colonial Dr
New Castle, IN 47362-5414
Phone (765) 465-2902

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
20041452AINMDForensic Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1239926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1164665378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W COLONIAL DR",
            "city": "NEW CASTLE",
            "state": "IN",
            "postal_code": "473625414",
            "telephone_number": "765-465-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W COLONIAL DR",
            "city": "NEW CASTLE",
            "state": "IN",
            "postal_code": "473625414",
            "telephone_number": "765-465-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOHN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-17",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041452A",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "IN",
            "license": "20041452A",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "IN",
            "license": "20041452A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Castle, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; 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.