Active NPI
David G Martin, M.ED., BCBA
- Behavior Analyst
- Clarksville, TN
National Provider Identifier
1407250392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-14-9787
- Practice address
- 279 Clear Sky CT
Suite C
Clarksville, TN 37043-5946 - Phone
- (615) 613-1869
- Fax
- (931) 919-2191
- NPI assigned
- Oct 21, 2014
- Sex
- Male
- 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 Analyst | 103K00000X | 1-14-9787 | TN | Primary |
Addresses
Primary practice location
279 Clear Sky CT
Suite C
Clarksville, TN 37043-5946
Mailing address
1853 Madison St
Unit 8
Clarksville, TN 37043-5299
Phone (615) 613-1869
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-14-9787 | Other | BACB CERTIFICATION NUMBER |
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
- Credentials
- Master of Education
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin Center for ABA and Behavioral Services, LLC | Behavior Analyst | Current | Accepting new patients |
| Magnolia ABA Institute, Inc | Behavior Analyst | Past | Accepting new patients |
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.
-
- Behavior Analyst
- Clarksville, TN
- NPI 1700210192
-
- Behavior Analyst
- Clarksville, TN
- NPI 1205380920
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413849600000",
"number": "1407250392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1853 MADISON ST",
"address_2": "UNIT 8",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370435299",
"telephone_number": "615-613-1869",
"fax_number": "931-919-2191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "279 CLEAR SKY CT",
"address_2": "SUITE C",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370435946",
"telephone_number": "615-613-1869",
"fax_number": "931-919-2191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "DAVID",
"middle_name": "G",
"credential": "M.ED., BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-21",
"last_updated": "2014-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TN",
"license": "1-14-9787",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BACB CERTIFICATION NUMBER",
"identifier": "1-14-9787",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.