Active NPI
Benjamin Reid Martin, DPT
- Physical Therapist
- Tinker Afb, OK
National Provider Identifier
1336575489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4715
- Practice address
- 7050 Air Depot Blvd Ste 1094
Tinker Afb, OK 73145-8716 - Phone
- (405) 205-0249
- NPI assigned
- Sep 20, 2013
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4715 | OK | Primary |
Addresses
Primary practice location
7050 Air Depot Blvd Ste 1094
Tinker Afb, OK 73145-8716
Mailing address
921 NE 13TH St
Oklahoma City, OK 73104-5007
Phone (405) 456-3905
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 |
|---|---|---|---|
| 4715 | OK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1336575489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "921 NE 13TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731045007",
"telephone_number": "405-456-3905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7050 AIR DEPOT BLVD STE 1094",
"city": "TINKER AFB",
"state": "OK",
"postal_code": "731458716",
"telephone_number": "405-205-0249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "BENJAMIN",
"middle_name": "REID",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-20",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "4715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinker Afb, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.