Active NPI
Larry J Martin, PH.D.
- Social Worker
- Grand Ledge, MI
National Provider Identifier
1487850822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801059535
- Practice address
- 6736 Willow Hwy
Grand Ledge, MI 48837-8974 - Phone
- (517) 622-0054
- Fax
- (517) 622-0054
- NPI assigned
- Jun 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801059535 | MI | Primary |
Addresses
Primary practice location
6736 Willow Hwy
Grand Ledge, MI 48837-8974
Mailing address
6736 Willow Hwy
Grand Ledge, MI 48837-8974
Phone (517) 622-0054
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801059535 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487850822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6736 WILLOW HWY",
"city": "GRAND LEDGE",
"state": "MI",
"postal_code": "488378974",
"telephone_number": "517-622-0054",
"fax_number": "517-622-0054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6736 WILLOW HWY",
"city": "GRAND LEDGE",
"state": "MI",
"postal_code": "488378974",
"telephone_number": "517-622-0054",
"fax_number": "517-622-0054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "LARRY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801059535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Ledge, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.