Micheal Shawn Martin, MPT,ATC,CSCS,PES

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2890 Issued in AR

Practice address

3900 N Parkview Dr
Fayetteville, AR 72703-6398

Phone

(479) 966-4187

Fax

(479) 967-9658

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Guidroz Physical Therapy LLC

  • Physical Therapist
  • Natchitoches, LA
  • NPI 1730138835
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1730230418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 W TUPELO WAY",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046478",
            "telephone_number": "479-200-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 N PARKVIEW DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036398",
            "telephone_number": "479-966-4187",
            "fax_number": "479-967-9658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MICHEAL",
        "middle_name": "SHAWN",
        "name_prefix": "Mr.",
        "credential": "MPT,ATC,CSCS,PES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "2890",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AR",
            "license": "234",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer A Martin
• Joel Thomas Martin
• Julie Martin, ATC
• Katey Nicole Martin
• Mackenzie Rose Martin, DC
• Robert Edward Martin
• William C Martin, MD
• Blakelyn Martindale
• Gustavo Kennedy Martinez, PT, DPT
• Jenny Martinez

• Physical Therapist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.

Verify at the official NPI Registry.