Active NPI
Royal Martin
- Addiction (Substance Use Disorder) Counselor
- Canton, OH
National Provider Identifier
1588050553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 140719-PRE
- Practice address
- 1341 Market Ave N
Canton, OH 44714-2605 - Phone
- (330) 453-8252
- NPI assigned
- Apr 7, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 140719-PRE | OH | Primary |
Addresses
Primary practice location
1341 Market Ave N
Canton, OH 44714-2605
Mailing address
1341 Market Ave N
Canton, OH 44714-2605
Phone (330) 453-8252
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2901131 | Medicaid | OH |
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 |
|---|---|---|---|
| 140719-PRE | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428364800000",
"number": "1588050553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1341 MARKET AVE N",
"city": "CANTON",
"state": "OH",
"postal_code": "447142605",
"telephone_number": "330-453-8252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1341 MARKET AVE N",
"city": "CANTON",
"state": "OH",
"postal_code": "447142605",
"telephone_number": "330-453-8252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ROYAL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-07",
"last_updated": "2015-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "140719-PRE",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2901131",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.