Active NPI
Abby Denise Martin, PTA
- Physical Therapy Assistant
- Caribou, ME
National Provider Identifier
1699239061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PA4682
- Practice address
- 163 Van Buren Rd Ste 1
Caribou, ME 04736-3588 - Phone
- (207) 834-3387
- NPI assigned
- Jan 30, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PA4682 | ME | Primary |
Addresses
Primary practice location
163 Van Buren Rd Ste 1
Caribou, ME 04736-3588
Mailing address
24 Sweden St
Caribou, ME 04736-2127
Phone (207) 498-3111
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA4682 | ME | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1699239061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 SWEDEN ST",
"city": "CARIBOU",
"state": "ME",
"postal_code": "047362127",
"telephone_number": "207-498-3111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 VAN BUREN RD STE 1",
"city": "CARIBOU",
"state": "ME",
"postal_code": "047363588",
"telephone_number": "207-834-3387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ABBY",
"middle_name": "DENISE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-30",
"last_updated": "2020-10-26",
"certification_date": "2020-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "ME",
"license": "PA4682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caribou, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.