NPIMap

Organization Active NPI

Stacy Martin, LLC

  • Community/Behavioral Health Agency
  • Gahanna, OH
National Provider Identifier
1174076699
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
STACY MARTIN, LLC
Practice address
882 Eastchester Dr
Gahanna, OH 43230-5137
Phone
(919) 771-3930
NPI assigned
Aug 2, 2016
Last updated
Mar 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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

Authorized official

Name
Mrs. Stacy Martin, BCBA, COBANPI 1760688907
Title
Owner
Phone
(919) 771-3930

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

882 Eastchester Dr
Gahanna, OH 43230-5137

Mailing address

882 Eastchester Dr
Gahanna, OH 43230-5137
Phone (919) 771-3930

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520380800000",
    "number": "1174076699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 EASTCHESTER DR",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432305137",
            "telephone_number": "919-771-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 EASTCHESTER DR",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432305137",
            "telephone_number": "919-771-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY MARTIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-02",
        "last_updated": "2018-03-07",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-771-3930",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA, COBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gahanna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; 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.