Active NPI
Marissa C Martini, SLP
- Speech-Language Pathologist
- Lincoln, NE
National Provider Identifier
1205618154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 993
- Practice address
- 5930 Vandervoort Dr
Lincoln, NE 68516-2391 - Phone
- (402) 420-2099
- Fax
- (402) 420-2823
- NPI assigned
- Oct 16, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 993 | NE | Primary |
Addresses
Primary practice location
5930 Vandervoort Dr
Lincoln, NE 68516-2391
Mailing address
PO Box 24607
Omaha, NE 68124-0607
Phone (402) 955-5400
Other practice location 1
17809 Pierce Plz
Omaha, NE 68130-1035
Phone (402) 955-8181
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 |
|---|---|---|---|
| 993 | NE | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital | Past | Accepting new patients | |
| Children'S Specialty Physician Billing | Past | Accepting new patients | |
| Nebraska Pediatric Practice, Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
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- Omaha, NE
- NPI 1518091230
-
- Pediatric Nurse Practitioner
- Omaha, NE
- NPI 1013040369
-
- Pediatrics Physician
- Omaha, NE
- NPI 1144556333
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697414400000",
"number": "1205618154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 24607",
"city": "OMAHA",
"state": "NE",
"postal_code": "681240607",
"telephone_number": "402-955-5400",
"fax_number": "402-955-3674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5930 VANDERVOORT DR",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685162391",
"telephone_number": "402-420-2099",
"fax_number": "402-420-2823"
}
],
"practiceLocations": [
{
"address_1": "17809 Pierce Plz",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681301035",
"country_code": "US",
"telephone_number": "402-955-8181",
"fax_number": "402-955-8188",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTINI",
"first_name": "MARISSA",
"middle_name": "C",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-16",
"last_updated": "2023-10-16",
"certification_date": "2023-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NE",
"license": "993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.