Audra Martin, PHD,LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1440233-SUPV Issued in OH

Practice address

116 Cleveland Ave NW Ste 555
Canton, OH 44702-1749

Phone

(330) 915-8347

NPI assigned

Oct 8, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osh-Oh Physicians Group PCGroup PAC ID 1759639693, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Osh-Oh Physicians Group PC

  • Primary Care Clinic/Center
  • Cleveland, OH
  • NPI 1346747946

  Clinical

  Medicare reassignment Care Compare group NPD
• House of G.R.a.C.E.Residential Services, LLC

  • Home Health Agency
  • Canton, OH
  • NPI 1235750753
  NPD Authorized official

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1184443996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 CLEVELAND AVE NW STE 555",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021749",
            "telephone_number": "330-915-8347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 CLEVELAND AVE NW STE 555",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021749",
            "telephone_number": "330-915-8347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "AUDRA",
        "credential": "PHD,LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.1440233-SUPV",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1440233-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Diane Marshall, PT
• Shayna Marshall, BA
• Alfred J Martello, MD
• Anna Martin
• Ashlie Taneel Martin, MD
• Bethany Martin
• Elise Martin, LPCC
• Gregg A Martin, PH.D.
• Gwendolyn G Martin, LSW
• Hilary Martin, CPRS

• Clinical Social Worker in Canton, OH
• Providers in Canton, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.