Ronald Alan Martin Jr., PROGRAM SPONSOR

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

License

2000872 Issued in NJ

Practice address

1305 Kings Hwy N
Cherry Hill, NJ 08034-1919

Phone

(856) 651-7826

Fax

(856) 229-7142

NPI assigned

May 18, 2021

Last updated

May 18, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Affinity Health Norfolk LLC

  • Methadone Clinic
  • Norfolk, VA
  • NPI 1316821598
  Authorized official Same address or phone

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1710551460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 KINGS HWY N",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341919",
            "telephone_number": "856-651-7826",
            "fax_number": "856-229-7142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 KINGS HWY N",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341919",
            "telephone_number": "856-651-7826",
            "fax_number": "856-229-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "RONALD",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PROGRAM SPONSOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NJ",
            "license": "2000872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000872",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ron.martin@affinityhealthclinics.com",
            "affiliation": "N",
            "endpointDescription": "Company Email",
            "address_1": "1305 Kings Hwy N",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080341919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shannon Lynn Martello
• Brooke M Martin, OT
• Eric L. Martin, M.D.
• Lesley Martin, DPT
• Rachele L Martin
• Sandrine N. Martin, PHYSICIAN ASSISTANT
• Sonia Martinez
• Judith Anne Martinson, OTRL
• Jaclyn E Martz, PT
• Rebecca Lynn Martz, MD

• Methadone Clinic in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Methadone Clinic in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.