Active NPI
Martin W George, MA
- Psychologist
- Maysville, KY
National Provider Identifier
1679592158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 035
- Practice address
- 611 Forest Ave
Maysville, KY 41056-1411 - Phone
- (606) 564-4016
- Fax
- (606) 564-8288
- NPI assigned
- Jul 18, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 035 | KY | Primary |
Addresses
Primary practice location
611 Forest Ave
Maysville, KY 41056-1411
Mailing address
611 Forest Ave
Maysville, KY 41056-1411
Phone (606) 564-4016
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30608012 | Medicaid | KY |
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 035 | KY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399507200000",
"number": "1679592158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 FOREST AVE",
"city": "MAYSVILLE",
"state": "KY",
"postal_code": "410561411",
"telephone_number": "606-564-4016",
"fax_number": "606-564-8288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 FOREST AVE",
"city": "MAYSVILLE",
"state": "KY",
"postal_code": "410561411",
"telephone_number": "606-564-4016",
"fax_number": "606-564-8288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "MARTIN",
"middle_name": "W",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2014-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "KY",
"license": "035",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30608012",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maysville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.