Clint Lee Martineau, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

69898827-4405 Issued in UT

Practice address

Corner of Route N12 and N7
Fort Defiance, AZ 96504

Phone

(928) 729-8000

NPI assigned

Oct 28, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, TX2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Fort Defiance Indian Hospital Board, IncorporationGroup PAC ID 0941336697, 153 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fort Defiance Indian Hospital Hospital, Ft. Defiance, AZ, CCN 030071

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• The Fort Defiance Indian Hospital Board, Incorporation

  dba Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1477876639

  TX

  Medicare reassignment Care Compare group NPD
• St. George Children & Family Psychiatric Center PC

  • Specialist
  • St George, UT
  • NPI 1225326044
  Medicare reassignment NPD

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

{
    "created_epoch": "1540684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1821565839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "96504",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5965 S 900 E Ste 100",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841211850",
            "country_code": "US",
            "telephone_number": "801-872-5516",
            "fax_number": "801-212-9942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEAU",
        "first_name": "CLINT",
        "middle_name": "LEE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-28",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "69898827-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeri Manuelito, RN, BSN
• Marek Marcinkiewicz, MD
• Kimberley Marcontell
• Peter Joseph Marinich, CRNA
• Laurence Martin, MD
• Anthony Paul Martinez
• Francisco David Martinez
• Brigette Mastel, CNM
• Kyle Maxum
• Michele Nicole Mazeres, MPH, RD

• Psychiatric/Mental Health Nurse Practitioner in Fort Defiance, AZ
• Providers in Fort Defiance, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.