Active NPI
George Martin, LP
- Psychologist
- Little Canada, MN
National Provider Identifier
1245394352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP1095
- Practice address
- 127 County Road C E Ste 5
Little Canada, MN 55117-1383 - Phone
- (651) 263-2606
- NPI assigned
- Dec 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP1095 | MN | Primary |
Addresses
Primary practice location
127 County Road C E Ste 5
Little Canada, MN 55117-1383
Mailing address
127 County Road C E Ste 5
Little Canada, MN 55117-1383
Phone (651) 263-2606
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 |
|---|---|---|---|
| LP1095 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1245394352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 COUNTY ROAD C E STE 5",
"city": "LITTLE CANADA",
"state": "MN",
"postal_code": "551171383",
"telephone_number": "651-263-2606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 COUNTY ROAD C E STE 5",
"city": "LITTLE CANADA",
"state": "MN",
"postal_code": "551171383",
"telephone_number": "651-263-2606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "GEORGE",
"name_prefix": "Mr.",
"credential": "LP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP1095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Canada, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.