Individual provider Active NPI

Eric James Martin, LSCSW, LMAC

  • Clinical Social Worker
  • Manhattan, KS
National Provider Identifier
1396193538
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4993 Issued in KS
Practice address
1558 Hayes Dr
Manhattan, KS 66502-5068
Phone
(785) 587-4315
Fax
(785) 587-4339
NPI assigned
May 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 294 KS
Social Worker 104100000X 9954 KS
Clinical Social Worker 1041C0700X 4993 KS Primary

Addresses

Primary practice location

1558 Hayes Dr
Manhattan, KS 66502-5068

Mailing address

PO Box 747
Manhattan, KS 66505-0747
Phone (785) 587-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190805002340 KS Practitioner - Clinical Social Worker 0143557736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pawnee Mental Health Service IncGroup PAC ID 3870406820, 29 clinicians

Practice addresses (Care Compare)

1558 Hayes Dr
Manhattan, KS 66502-5068
Phone (785) 587-4431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
294KSMDClinical Psychologist
9954KSMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pawnee Mental Health Service, Inc. CurrentSince Jul 22, 2019 Accepting new patients
Pawnee Mental Health Service, Inc. CurrentSince Jul 22, 2019 Accepting new patients

Locations

1836 M St
Belleville, KS 66935
Phone (785) 527-2549

2020 N Independence Ave
Beloit, KS 67420
Phone (785) 738-3261

207 N Mill St
Ste 5
Beloit, KS 67420
Phone (785) 738-5363

503 Grant Ave
Clay Center, KS 67432
Phone (785) 632-2108

210 W 21st St
Concordia, KS 66901
Phone (785) 243-8900

814 Caroline Ave
Junction City, KS 66441
Phone (785) 762-5250

1735 W Ash St
Junction City, KS 66441
Phone (785) 238-1085

2001 Claflin Rd
Manhattan, KS 66502

1650 Hayes Dr
Manhattan, KS 66502
Phone (785) 587-4333

3019 Anderson Ave
Manhattan, KS 66503
Phone (785) 313-0900

1558 Hayes Dr
Manhattan, KS 66502
Phone (785) 587-4315

122 W Main St
Mankato, KS 66956
Phone (785) 378-3898

406 N 3rd St
Ste 3
Marysville, KS 66508
Phone (785) 562-3907

510 E US Highway 24
Wamego, KS 66547
Phone (785) 456-7408

321 C St
Washington, KS 66968

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1396193538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 747",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665050747",
            "telephone_number": "785-587-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1558 HAYES DR",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665025068",
            "telephone_number": "785-587-4315",
            "fax_number": "785-587-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ERIC",
        "middle_name": "JAMES",
        "credential": "LSCSW, LMAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-27",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "294",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "9954",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan, KS

Sources for this page

Verify at the official NPI Registry.