Active NPI
Richard J Martin, LMSW
- Social Worker
- Trumann, AR
National Provider Identifier
1760669014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6539-M
- Practice address
- 1704 Highway 69 West
Trumann, AR 72472-2029 - Phone
- (870) 483-4003
- Fax
- (870) 483-4009
- NPI assigned
- Jan 29, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Social Worker | 104100000X | 6539-M | AR | Primary |
Addresses
Primary practice location
1704 Highway 69 West
Trumann, AR 72472-2029
Mailing address
1815 Pleasant Grove Rd
Jonesboro, AR 72401-7870
Phone (870) 933-6886
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 173917795 | Medicaid | AR |
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 |
|---|---|---|---|
| 6539-M | AR | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525824000000",
"number": "1760669014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 PLEASANT GROVE RD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724017870",
"telephone_number": "870-933-6886",
"fax_number": "870-933-9395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1704 HIGHWAY 69 WEST",
"city": "TRUMANN",
"state": "AR",
"postal_code": "724722029",
"telephone_number": "870-483-4003",
"fax_number": "870-483-4009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "RICHARD",
"middle_name": "J",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-29",
"last_updated": "2018-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AR",
"license": "6539-M",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "173917795",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Trumann, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.