Active NPI
Stacia J Martin, OTR/L
- Occupational Therapist
- Andover, NH
National Provider Identifier
1336168178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1336
- Practice address
- 327 Chase Hill Rd
Andover, NH 03216-4109 - Phone
- (603) 496-5214
- Fax
- (603) 776-0381
- NPI assigned
- Jul 19, 2006
- Last updated
- Aug 6, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1336 | NH | Primary |
Addresses
Primary practice location
327 Chase Hill Rd
Andover, NH 03216-4109
Mailing address
327 Chase Hill Rd
Andover, NH 03216-4109
Phone (603) 496-5214
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13Y008938NH01 | Other | NH | ANTHEM BC/BS |
| 30413840 | Medicaid | NH | |
| 386488 | Other | NH | MVP |
| 1065349 | Other | NH | AETNA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1336 | NH | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthways Family Practice LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Manchester, NH
- NPI 1073554770
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628208000000",
"number": "1336168178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "327 CHASE HILL RD",
"city": "ANDOVER",
"state": "NH",
"postal_code": "032164109",
"telephone_number": "603-496-5214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "327 CHASE HILL RD",
"city": "ANDOVER",
"state": "NH",
"postal_code": "032164109",
"telephone_number": "603-496-5214",
"fax_number": "603-776-0381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "STACIA",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2021-08-06",
"certification_date": "2021-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NH",
"license": "1336",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "13Y008938NH01",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30413840",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "386488",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "1065349",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Andover, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.