Active NPI
Richard Allen Martin, PHD,MBA
- Psychologist
- Pella, IA
National Provider Identifier
1720591183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 00317
- Practice address
- 1402 Washington St
Pella, IA 50219-1502 - Phone
- (641) 204-0055
- NPI assigned
- Nov 8, 2017
- Last updated
- Apr 6, 2018
- 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 | 00317 | IA | Primary |
Addresses
Primary practice location
1402 Washington St
Pella, IA 50219-1502
Mailing address
1402 Washington St
Pella, IA 50219-1502
Phone (641) 780-1087
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
- Master of Business Administration, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00317 | IA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deborah Kay-Ostrander Dba Keys to Success | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Addiction (Substance Use Disorder) Counselor
- Pella, IA
- NPI 1497268858
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522972800000",
"number": "1720591183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1402 WASHINGTON ST",
"city": "PELLA",
"state": "IA",
"postal_code": "502191502",
"telephone_number": "641-780-1087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1402 WASHINGTON ST",
"city": "PELLA",
"state": "IA",
"postal_code": "502191502",
"telephone_number": "641-204-0055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "RICHARD",
"middle_name": "ALLEN",
"credential": "PHD,MBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-08",
"last_updated": "2018-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IA",
"license": "00317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pella, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.