Individual provider Active NPI

Gregg A Martin, PH.D.

  • Psychologist
  • Canton, OH
National Provider Identifier
1174694558
Registry record updated Mar 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4547 Issued in OH
Practice address
4760 Belpar St NW
Canton, OH 44718-3603
Phone
(330) 492-9200
Fax
(330) 492-5454
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4547 OH Primary
Rehabilitation Psychologist 103TR0400X 4547 OH

Addresses

Primary practice location

4760 Belpar St NW
Canton, OH 44718-3603

Mailing address

4760 Belpar St NW
Canton, OH 44718-3603
Phone (330) 492-9200

Other identifiers 1

IdentifierTypeStateIssuer
0888722MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110502000464 OH Practitioner - Clinical Psychologist 4082899372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Michigan State University College of Human Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthounited, Inc.Group PAC ID 9032197868, 89 clinicians

Practice addresses (Care Compare)

4760 Belpar St NW
Canton, OH 44718-3603
Phone (330) 492-9200

Merit-based Incentive Payment System (MIPS)

Final score
80.13 of 100Reported as group
Quality
74.6
Promoting interoperability
70
Improvement activities
40
Cost
84.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Orthounited, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Orthounited, Inc. CurrentSince Jan 1, 2023 Accepting new patients

Locations

325 Springside Dr
Ste 101
Akron, OH 44333
Phone (330) 492-9200

325 Springside Dr
Ste 101OH
Akron, OH 44333

4760 Belpar St NW
Canton, OH 44718
Phone (330) 244-1001

7442 Frank Ave NW
North Canton, OH 44720
Phone (330) 305-0838

Interoperability endpoints

  • Direct secure messaging: gmartin@omni.medentdirect.com

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300579200000",
    "number": "1174694558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 BELPAR ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183603",
            "telephone_number": "330-492-9200",
            "fax_number": "330-492-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 BELPAR ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183603",
            "telephone_number": "330-492-9200",
            "fax_number": "330-492-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "GREGG",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2011-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4547",
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "OH",
            "license": "4547",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0888722",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.