Individual provider Active NPI

Mayra Martins

  • Behavior Analyst
  • Salt Lake City, UT
National Provider Identifier
1972963387
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
103085222506 Issued in UT
Practice address
938 S Washington St Apt 203
Salt Lake City, UT 84101-3017
Phone
(925) 338-4764
NPI assigned
Feb 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X
Behavior Analyst 103K00000X 103085222506 UT Primary

Addresses

Primary practice location

938 S Washington St Apt 203
Salt Lake City, UT 84101-3017

Mailing address

938 S Washington St Apt 203
Salt Lake City, UT 84101-3017

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

LicenseStateTypeSpecialty
103085222506UTMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Autism Center Behavior Analyst Current Accepting new patients

Locations

2540 E Bengal Blvd
Ste 300
Cottonwood Heights, UT 84121
Phone (801) 495-5100

2540 E Bengal Blvd
Cottonwood Heights, UT 84121
Phone (801) 495-5105

1106 E 6600 S
Murray, UT 84121
Phone (801) 930-5266

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1972963387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 S WASHINGTON ST APT 203",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841013017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 S WASHINGTON ST APT 203",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841013017",
            "telephone_number": "925-338-4764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINS",
        "first_name": "MAYRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "UT",
            "license": "103085222506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.