Kellie Martens

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301016782 Issued in MI

Practice address

1 Ford PL
Detroit, MI 48202-3450

Phone

(843) 725-9803

NPI assigned

Jul 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Henry Ford Health System

  • Clinical Psychologist
  • Detroit, MI
  • NPI 1114001468
  Medicare reassignment Care Compare group
• W. a. Foote Memorial Hospital, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jackson, MI
  • NPI 1326078866
  Medicare reassignment NPD
• W.a. Foote Memorial Hospital, Inc

  • Clinical Psychologist
  • Jackson, MI
  • NPI 1417494378
  NPD
• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615593600000",
    "number": "1780107029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18760 WALMER LN",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255251",
            "telephone_number": "843-725-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FORD PL",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "843-725-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTENS",
        "first_name": "KELLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2021-03-13",
        "certification_date": "2021-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmartens363963@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole Marshke, LMSW
• Virgil Marshll II
• Lisa Nicole Marszalec, MA LPC
• Cary Martens, MPT
• Karen Ann Martens, PA
• Symone Leslie Martin Fowler, MD
• Lindsay Marie Martin-Engel, M.D.
• Jessie Yvonne Martin-Ford, LMSW,ACSW
• Pamela Martin-Kimbrough, PA-C
• Lori E Martin-Spratling, LBSW, M.ED

• Clinical Psychologist in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.