Active NPI
Cory Jon Martin, LCSW, MPA
- Clinical Social Worker
- Eugene, OR
National Provider Identifier
1427385244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7238604-3501
- Practice address
- 211 E 7TH Ave
Eugene, OR 97401-2773 - Phone
- (541) 242-0460
- NPI assigned
- Nov 16, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 7238604-3502 | UT | |
| Clinical Social Worker | 1041C0700X | 7238604-3501 | UT | Primary |
Addresses
Primary practice location
211 E 7TH Ave
Eugene, OR 97401-2773
Mailing address
913 NW Garden Valley Blvd
Roseburg, OR 97471-6523
Phone (541) 242-0460
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7238604-3502 | Other | UT | STATE OF UTAH DEPARTMENT OF PROFESSIONAL LICENSING |
| 7238604-3501 | Other | UT | STATE OF UTAH - DEPARTMENT OF COMMERCE |
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 |
|---|---|---|---|
| 7238604-3502 | UT | MD | Social Worker |
| 7238604-3501 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328832000000",
"number": "1427385244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "913 NW GARDEN VALLEY BLVD",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974716523",
"telephone_number": "541-242-0460",
"fax_number": "541-465-6602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 E 7TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974012773",
"telephone_number": "541-242-0460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "CORY",
"middle_name": "JON",
"name_prefix": "Mr.",
"credential": "LCSW, MPA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-11-16",
"last_updated": "2012-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "7238604-3502",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "7238604-3501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF UTAH DEPARTMENT OF PROFESSIONAL LICENSING",
"identifier": "7238604-3502",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF UTAH - DEPARTMENT OF COMMERCE",
"identifier": "7238604-3501",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.