Individual provider Active NPI

Annie Billie Jean Martinez

  • Counselor
  • Portland, OR
National Provider Identifier
1295103158
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CADCI18-P-10 Issued in OR
Practice address
200 SE 7TH Ave
Portland, OR 97214-1200
Phone
(503) 235-0131
Fax
(503) 239-7390
NPI assigned
Sep 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CADCI18-P-10 OR Primary
Peer Specialist 175T00000X

Addresses

Primary practice location

200 SE 7TH Ave
Portland, OR 97214-1200

Mailing address

15945 SE Mill St
Portland, OR 97233-3663
Phone (503) 572-7089

Other names 1

  • Ms. Annie Billie Jean Jones Martinez Former name

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

LicenseStateTypeSpecialty
CADCI18-P-10ORMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Volunteers of America Inc. Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1295103158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15945 SE MILL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972333663",
            "telephone_number": "503-572-7089",
            "fax_number": "503-239-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SE 7TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141200",
            "telephone_number": "503-235-0131",
            "fax_number": "503-239-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ANNIE",
        "middle_name": "BILLIE JEAN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-09",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "CADCI18-P-10",
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "JONES MARTINEZ",
            "middle_name": "BILLIE JEAN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.