NPIMap

Individual provider Active NPI

Gary Dewayne Martin Jr., D.C.

  • Neurology Chiropractor
  • Dallas, TX
National Provider Identifier
1326126673
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
6457 Issued in TX
Practice address
14444 Dallas Pkwy
Suite 115
Dallas, TX 75254-8304
Phone
(972) 789-1234
Fax
(972) 789-1589
NPI assigned
Nov 2, 2006
Last updated
Apr 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X 6457 TX Primary

Addresses

Primary practice location

14444 Dallas Pkwy
Suite 115
Dallas, TX 75254-8304

Mailing address

14444 Dallas Pkwy
Suite 115
Dallas, TX 75254-8304
Phone (972) 789-1234

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

State licenses

LicenseStateTypeSpecialty
6457TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Innate Medical Solutions PLLC Past Accepting new patients
Innate Medical Solutions PLLC Past Accepting new patients
Innate Medical Solutions PLLC Past Accepting new patients
Innate Medical Solutions PLLC Past Accepting new patients
Innate Medical Solutions PLLC Past Accepting new patients
Innate Medical Solutions PLLC Past Accepting new patients
Innate Medical Solutions PLLC Past Accepting new patients
Innate Medical Solutions PLLC Past Accepting new patients
Innate Medical Solutions PLLC Past Accepting new patients

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1326126673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14444 DALLAS PKWY",
            "address_2": "SUITE 115",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548304",
            "telephone_number": "972-789-1234",
            "fax_number": "972-789-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14444 DALLAS PKWY",
            "address_2": "SUITE 115",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548304",
            "telephone_number": "972-789-1234",
            "fax_number": "972-789-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "GARY",
        "middle_name": "DEWAYNE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "TX",
            "license": "6457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; 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.