Individual provider Active NPI

Angela M Martinez, LCSW

  • Social Worker
  • Logan, UT
National Provider Identifier
1447566245
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1300 N 500 E FL 3
Logan, UT 84341-2408
Phone
(435) 716-5790
NPI assigned
Aug 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

1300 N 500 E FL 3
Logan, UT 84341-2408

Mailing address

1300 N 500 E FL 3
Logan, UT 84341-2408
Phone (435) 716-5790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20150323001152 UT Practitioner - Clinical Social Worker 0840517389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1350 N 500
Logan, UT 84341-2400
Phone (435) 792-1980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Mar 1, 2015 Accepting new patients
Ihc Health Services Inc CurrentSince Mar 1, 2015 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

4088 N Highway 91
Hyde Park, UT 84318
Phone (435) 563-4888

1300 N 500 E
Fl 3
Logan, UT 84341
Phone (435) 716-5790

412 N 200 E
Logan, UT 84321
Phone (435) 713-2710

1400 N 500 E
North Logan, UT 84341
Phone (435) 716-1000

1350 N 500 E
North Logan, UT 84341
Phone (435) 716-2800

Organizations & group practices 3

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": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424131200000",
    "number": "1447566245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 500 E FL 3",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412408",
            "telephone_number": "435-716-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 500 E FL 3",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412408",
            "telephone_number": "435-716-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2015-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.