Gustavo Kennedy Martinez, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5647 Issued in AR

Practice address

3434 N Crossover Rd
Fayetteville, AR 72703-4576

Phone

(479) 480-7739

NPI assigned

Jan 29, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Select Rehabilitation, LLC

  • Physical Medicine & Rehabilitation Physician
  • Fayetteville, AR
  • NPI 1780505503
  NPD (past)

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1306608955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 SUNDOWNER RANCH AVE",
            "city": "PRAIRIE GROVE",
            "state": "AR",
            "postal_code": "727538441",
            "telephone_number": "580-649-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 N CROSSOVER RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034576",
            "telephone_number": "479-480-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "GUSTAVO",
        "middle_name": "KENNEDY",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-29",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "5647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Rose Martin, DC
• Micheal Shawn Martin, MPT,ATC,CSCS,PES
• Robert Edward Martin
• William C Martin, MD
• Blakelyn Martindale
• Jenny Martinez
• Joselyn Alexandra Martinez
• Marty Hurlbut, M.D., PA
• Jasmen Marty
• Samantha Marveggio, MHPP

• Physical Therapist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.