Active NPI
Jennifer Martino
- Assistive Technology Supplier Rehabilitation Counselor
- Gold Beach, OR
National Provider Identifier
1386500114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistive Technology Supplier Rehabilitation Counselor
- License
- 055211711
- Practice address
- 94667 N Bank Pistol River Rd
Gold Beach, OR 97444-9665 - Phone
- (360) 499-8785
- Fax
- (000) 000-0000
- NPI assigned
- Dec 23, 2025
- 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 |
|---|---|---|---|---|
| Assistive Technology Supplier Rehabilitation Counselor | 225CA2500X | 055211711 | OR | Primary |
Addresses
Primary practice location
94667 N Bank Pistol River Rd
Gold Beach, OR 97444-9665
Mailing address
94667 N Bank Pistol River Rd
Gold Beach, OR 97444-9665
Phone (360) 499-8785
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055211711 | OR | MD | Assistive Technology Supplier Rehabilitation Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766448000000",
"number": "1386500114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94667 N BANK PISTOL RIVER RD",
"city": "GOLD BEACH",
"state": "OR",
"postal_code": "974449665",
"telephone_number": "360-499-8785",
"fax_number": "000-000-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94667 N BANK PISTOL RIVER RD",
"city": "GOLD BEACH",
"state": "OR",
"postal_code": "974449665",
"telephone_number": "360-499-8785",
"fax_number": "000-000-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINO",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-12-23",
"last_updated": "2025-12-23",
"certification_date": "2025-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "225CA2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Rehabilitation Counselor, Assistive Technology Supplier",
"state": "OR",
"license": "055211711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gold Beach, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.