Active NPI
Jeffrey Bryan Sison Martinez, OTR/L
- Pediatric Occupational Therapist
- Henderson, NV
National Provider Identifier
1730424565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 12-0281
- Practice address
- 1024 Ginseng CT
Henderson, NV 89052-5008 - Phone
- (818) 645-6082
- NPI assigned
- Dec 5, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 12-0281 | NV | |
| Feeding, Eating & Swallowing Occupational Therapist | 225XF0002X | 12-0281 | NV | |
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 12-0281 | NV | |
| Pediatric Occupational Therapist | 225XP0200X | 12-0281 | NV | Primary |
Addresses
Primary practice location
1024 Ginseng CT
Henderson, NV 89052-5008
Mailing address
1024 Ginseng CT
Henderson, NV 89052-5008
Phone (818) 645-6082
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12-0281 | NV | MD | Feeding, Eating & Swallowing Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354665600000",
"number": "1730424565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1024 GINSENG CT",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890525008",
"telephone_number": "818-645-6082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1024 GINSENG CT",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890525008",
"telephone_number": "818-645-6082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "JEFFREY",
"middle_name": "BRYAN SISON",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-05",
"last_updated": "2012-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NV",
"license": "12-0281",
"primary": false
},
{
"code": "225XF0002X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Feeding, Eating & Swallowing",
"state": "NV",
"license": "12-0281",
"primary": false
},
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "NV",
"license": "12-0281",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NV",
"license": "12-0281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.