Individual provider Active NPI

David Guy Martino, PHD

  • Clinical Psychologist
  • Iowa City, IA
National Provider Identifier
1265421747
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
00754 Issued in IA
Practice address
209 E Washington St
Suite 202
Iowa City, IA 52240-3909
Phone
(319) 354-3232
Fax
(319) 354-2990
NPI assigned
Oct 18, 2005
Last updated
Sep 9, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 00754 IA Primary

Addresses

Primary practice location

209 E Washington St
Suite 202
Iowa City, IA 52240-3909

Mailing address

209 E Washington St
Suite 202
Iowa City, IA 52240-3909
Phone (319) 354-3232

Other identifiers 1

IdentifierTypeStateIssuer
29335OtherIAWELLMARK BXBS

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
00754IAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Psychology Associates, P.C. PastSince Jan 1, 1999 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1265421747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 E WASHINGTON ST",
            "address_2": "SUITE 202",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522403909",
            "telephone_number": "319-354-3232",
            "fax_number": "319-354-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 E WASHINGTON ST",
            "address_2": "SUITE 202",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522403909",
            "telephone_number": "319-354-3232",
            "fax_number": "319-354-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINO",
        "first_name": "DAVID",
        "middle_name": "GUY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "00754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BXBS",
            "identifier": "29335",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; 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.