Janice Dianne Martin, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2046 Issued in TN

Practice address

1891 Old Trenton Road
Clarksville, TN 37040

Phone

(931) 552-4171

Fax

(931) 551-9485

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Family Wellness Center of Clarksville, PC

  • Clinical Psychologist
  • Clarksville, TN
  • NPI 1174769277
  NPD (past) Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1417977802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30429",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370400008",
            "telephone_number": "931-552-4171",
            "fax_number": "931-551-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 OLD TRENTON ROAD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37040",
            "telephone_number": "931-552-4171",
            "fax_number": "931-551-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JANICE",
        "middle_name": "DIANNE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TN",
            "license": "2046",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "2046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Center for ABA and Behavioral Services, LLC
• Jennifer Jo Martin Lane, OD
• David G Martin, M.ED., BCBA
• Graham Martin, M.A.
• Jacob Martin
• Kayla Martin
• Margaret Nelle Martin, RD, MS, CDE, LDN
• Nicola Elizabeth Martin, PHARMD
• Raquel Martin, PHD
• Sarah Martin

• Clinical Psychologist in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.