Active NPI
Michael Martin II
- Behavior Technician
- Colorado Springs, CO
National Provider Identifier
1184064032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 20-112720
- Practice address
- 1915 Aerotech Dr Ste 190
Colorado Springs, CO 80916-4213 - Phone
- (719) 301-5100
- NPI assigned
- Jun 25, 2013
- Last updated
- Feb 25, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 20-112720 | CO | Primary |
Addresses
Primary practice location
1915 Aerotech Dr Ste 190
Colorado Springs, CO 80916-4213
Mailing address
7483 Sandy Springs PT
Fountain, CO 80817-4074
Phone (620) 253-0790
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20-112720 | CO | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582588800000",
"number": "1184064032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7483 SANDY SPRINGS PT",
"city": "FOUNTAIN",
"state": "CO",
"postal_code": "808174074",
"telephone_number": "620-253-0790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1915 AEROTECH DR STE 190",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809164213",
"telephone_number": "719-301-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "MICHAEL",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-25",
"last_updated": "2020-02-25",
"certification_date": "2020-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CO",
"license": "20-112720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.