Active NPI
John Gilbert Martinez, M.D.
- Surgery Physician
- Ogden, UT
National Provider Identifier
1710957980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 7650579-1205
- Practice address
- 4403 Harrison Blvd
Suite 2600
Ogden, UT 84403-3271 - Phone
- (801) 387-4870
- NPI assigned
- Jan 23, 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 7979 | NV | |
| Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | 2083P0011X | 7979 | NV | |
| Surgery Physician | 208600000X | 7650579-1205 | UT | Primary |
| Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | 2083P0011X | 7650579-1205 | UT |
Addresses
Primary practice location
4403 Harrison Blvd
Suite 2600
Ogden, UT 84403-3271
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 387-4870
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0020-19807 | Medicaid | NV | |
| 1710957980 | Medicaid | UT |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7979 | NV | MD | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician |
| 7650579-1205 | UT | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296086400000",
"number": "1710957980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128",
"telephone_number": "801-387-4870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4403 HARRISON BLVD",
"address_2": "SUITE 2600",
"city": "OGDEN",
"state": "UT",
"postal_code": "844033271",
"telephone_number": "801-387-4870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "JOHN",
"middle_name": "GILBERT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2011-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NV",
"license": "7979",
"primary": false
},
{
"code": "2083P0011X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
"state": "NV",
"license": "7979",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "UT",
"license": "7650579-1205",
"primary": true
},
{
"code": "2083P0011X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
"state": "UT",
"license": "7650579-1205",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0020-19807",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1710957980",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.