Mary Wallace Martin

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

18157 Issued in NC

Practice address

2814 Gray Fox Rd
Monroe, NC 28110-8422

Phone

(704) 821-0568

NPI assigned

Dec 29, 2025

Last updated

Dec 29, 2025By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatric Boulevard, PLLC

  • Speech-Language Pathologist
  • Monroe, NC
  • NPI 1114233590

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1194681783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHADY LN",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296051260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 GRAY FOX RD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281108422",
            "telephone_number": "704-821-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MARY WALLACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-29",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "7820",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "18157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Don Levon Marsh
• Linda M Marshall, LPN
• Nicolo Marsoni, M.D.
• Lacey Lynn Martin, RN
• Larry Martin Jr., M.D
• Robin Martin
• William George Martin III, M.D.
• Sara Andrase Martinho, PA-C
• Massage at Monroe
• Mary H Massey, LCAS-A

• Occupational Therapist in Monroe, NC
• Providers in Monroe, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; 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.