Active NPI
Victoria Martyn
- Behavior Technician
- Tyrone, GA
National Provider Identifier
1962229161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 24331647
- Practice address
- 120 Handley Rd Ste 410
Tyrone, GA 30290-2174 - Phone
- (770) 629-4660
- NPI assigned
- Sep 20, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 24331647 | GA | Primary |
Addresses
Primary practice location
120 Handley Rd Ste 410
Tyrone, GA 30290-2174
Mailing address
6166 Sable Fox Dr
Riverdale, GA 30296-2322
Phone (404) 960-7469
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 |
|---|---|---|---|
| 24331647 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726790400000",
"number": "1962229161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6166 SABLE FOX DR",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302962322",
"telephone_number": "404-960-7469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 HANDLEY RD STE 410",
"city": "TYRONE",
"state": "GA",
"postal_code": "302902174",
"telephone_number": "770-629-4660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTYN",
"first_name": "VICTORIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-20",
"last_updated": "2024-09-20",
"certification_date": "2024-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "24331647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyrone, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.