Individual provider Active NPI

Erica Martineau

  • Speech-Language Pathologist
  • Lake Worth, TX
National Provider Identifier
1578043402
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
102498 Issued in TX
Practice address
3800 Marina Dr
Lake Worth, TX 76135-2835
Phone
(817) 237-7231
NPI assigned
Aug 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 102498 TX Primary

Addresses

Primary practice location

3800 Marina Dr
Lake Worth, TX 76135-2835

Mailing address

8210 Villa Lago Dr Apt 227
Fort Worth, TX 76179-2237
Phone (940) 453-9068

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

LicenseStateTypeSpecialty
102498TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1578043402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8210 VILLA LAGO DR APT 227",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761792237",
            "telephone_number": "940-453-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 MARINA DR",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761352835",
            "telephone_number": "817-237-7231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEAU",
        "first_name": "ERICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "102498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.