Alyssa Julianna Martin

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160010061 Issued in IL

Practice address

2025 E Lincoln St
Bloomington, IL 61701-5995

Phone

(309) 433-6172

NPI assigned

Jul 22, 2024

Last updated

Jul 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1366270340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 LONGDEN AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617018308",
            "telephone_number": "309-433-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 E LINCOLN ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015995",
            "telephone_number": "309-433-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ALYSSA",
        "middle_name": "JULIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160010061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Marquart, LPC
• Debra L Marquis, PT
• Kerri Marsh, LCPC
• Jalyn L Marshall
• Kimberly Diana Martin-Corcoran
• Ann K Martin, DPT
• Kenneth Noel Martin, MA, LPC
• Mark Randall Martin, L.C.P.C.
• William M Martin, R.PH.
• Polly Sue Masemore, PT

• Physical Therapy Assistant in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.

Verify at the official NPI Registry.