Active NPI
Will Martin
- Speech-Language Pathologist
- Grand Rapids, MN
National Provider Identifier
1245149665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1052906
- Practice address
- 822 NE 5TH Ave
Grand Rapids, MN 55744-2963 - Phone
- (218) 327-5739
- NPI assigned
- Sep 2, 2026
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1052906 | MN | Primary |
Addresses
Primary practice location
822 NE 5TH Ave
Grand Rapids, MN 55744-2963
Mailing address
822 NE 5TH Ave
Grand Rapids, MN 55744-2963
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1245149665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "822 NE 5TH AVE",
"city": "GRAND RAPIDS",
"state": "MN",
"postal_code": "557442963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "822 NE 5TH AVE",
"city": "GRAND RAPIDS",
"state": "MN",
"postal_code": "557442963",
"telephone_number": "218-327-5739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "WILL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-02",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MN",
"license": "1052906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.