Active NPI
Miranda Lynn Martin
- Behavior Technician
- Bend, OR
National Provider Identifier
1346824281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 19800 Village Office CT Ste 104
Bend, OR 97702-1813 - Phone
- (541) 306-3483
- NPI assigned
- May 6, 2021
- Last updated
- May 6, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | OR | Primary |
Addresses
Primary practice location
19800 Village Office CT Ste 104
Bend, OR 97702-1813
Mailing address
20184 Reed LN Apt 334
Bend, OR 97702-3781
Phone (406) 595-5784
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cascade Behavioral Intervention, 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620259200000",
"number": "1346824281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20184 REED LN APT 334",
"city": "BEND",
"state": "OR",
"postal_code": "977023781",
"telephone_number": "406-595-5784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19800 VILLAGE OFFICE CT STE 104",
"city": "BEND",
"state": "OR",
"postal_code": "977021813",
"telephone_number": "541-306-3483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "MIRANDA",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-06",
"last_updated": "2021-05-06",
"certification_date": "2021-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.