Active NPI
Martha Ann Clevenger, M.D.
- Psychiatry Physician
- Cambridge, MD
National Provider Identifier
1265628549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- D0057706
- Practice address
- 813-1 Chesapeake Drive
Cambridge, MD 21613-9401 - Phone
- (410) 221-2266
- Fax
- (410) 221-2878
- NPI assigned
- Sep 19, 2007
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | D0057706 | MD | Primary |
Addresses
Primary practice location
813-1 Chesapeake Drive
Cambridge, MD 21613-9401
Mailing address
813-1 Chesapeake Drive
Cambridge, MD 21613-9401
Phone (410) 221-2266
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 054707700 | Medicaid | MD | |
| 479302100 | Medicaid | MD |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0057706 | MD | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358294400000",
"number": "1265628549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "813-1 CHESAPEAKE DRIVE",
"city": "CAMBRIDGE",
"state": "MD",
"postal_code": "216139401",
"telephone_number": "410-221-2266",
"fax_number": "410-221-2878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813-1 CHESAPEAKE DRIVE",
"city": "CAMBRIDGE",
"state": "MD",
"postal_code": "216139401",
"telephone_number": "410-221-2266",
"fax_number": "410-221-2878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEVENGER",
"first_name": "MARTHA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-19",
"last_updated": "2013-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "D0057706",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "054707700",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "479302100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MD
- Choptank Community Health System, Inc.
- Sequoia Spring Chupek, LMSW
- Frank Peter Ciocci, MD
- Civic Health Services 3 LLC
- Meghan June Cleary, MSW, LCSW-C
- Coastal Health & Wellness, LLC
- Community Behavioral Health LLC
- Community Behavioral Health LLC
- Community Behavioral Health, LLC
- Community Behavioral Health, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.