NPIMap

Organization Active NPI

Dr. Larry Martin

  • Durable Medical Equipment & Medical Supplies
  • Albany, OR
National Provider Identifier
1194939405
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
062028 Issued in OR
Legal business name
DR. LARRY MARTIN
Practice address
905 4TH Ave SE
Albany, OR 97321-3104
Phone
(541) 812-2600
Fax
(541) 926-6047
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jon E Taylor
Title
Business Services Director
Phone
(541) 812-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 062028 OR Primary

Addresses

Primary practice location

905 4TH Ave SE
Albany, OR 97321-3104

Mailing address

905 4TH Ave SE
Albany, OR 97321-3104
Phone (541) 812-2600

Other identifiers 1

IdentifierTypeStateIssuer
NEW APPLICATIONMedicaidOR

Other names 1

  • LBL ESD Other name

National Provider Directory

National Provider Directory
Tax ID family
Dr Larry Martin6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194939405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 4TH AVE SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973213104",
            "telephone_number": "541-812-2600",
            "fax_number": "541-926-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 4TH AVE SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973213104",
            "telephone_number": "541-812-2600",
            "fax_number": "541-926-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. LARRY MARTIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BUSINESS SERVICES DIRECTOR",
        "authorized_official_telephone_number": "541-812-2600"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OR",
            "license": "062028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NEW APPLICATION",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LBL ESD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.