Active NPI
Michael Martin, RECOVERY ASSISTANT
- Case Manager/Care Coordinator
- Melbourne, AR
National Provider Identifier
1295035483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 104 Conniebrook LN
Melbourne, AR 72556-8861 - Phone
- (870) 368-5242
- NPI assigned
- Oct 22, 2010
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | AR | Primary |
Addresses
Primary practice location
104 Conniebrook LN
Melbourne, AR 72556-8861
Mailing address
PO Box 1589
Benton, AR 72018-1589
Phone (501) 315-3344
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308614400000",
"number": "1295035483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1589",
"city": "BENTON",
"state": "AR",
"postal_code": "720181589",
"telephone_number": "501-315-3344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 CONNIEBROOK LN",
"city": "MELBOURNE",
"state": "AR",
"postal_code": "725568861",
"telephone_number": "870-368-5242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "MICHAEL",
"credential": "RECOVERY ASSISTANT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-22",
"last_updated": "2011-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "AR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.