Individual provider Active NPI

Jennifer Martino

  • Assistive Technology Supplier Rehabilitation Counselor
  • Gold Beach, OR
National Provider Identifier
1386500114
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistive Technology Supplier Rehabilitation CounselorTaxonomy code 225CA2500X
License
055211711 Issued in OR
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

Updated by the provider on Dec 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistive Technology Supplier Rehabilitation CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 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

LicenseStateTypeSpecialty
055211711ORMDAssistive 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.

Verify at the official NPI Registry.