KELLY MARTIN (NPI# 1316330178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316330178 |
| Entity Type | Individual |
| Full Name | KELLY MARTIN |
| Credential | COTA |
| Practice Address |
12111 N 66th Ave Glendale AZ 85304-1625 |
| Practice Telephone | 5735690144 |
| Mailing Telephone | 5735690144 |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2015-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | 5909 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578100111 | Kelly Martin | Speech-Language Pathologist | 948 Dinosaur Dr, Erie, CO 80516-6576 | 2019-12-02 |
| 1386298677 | Kelly Marie Martin | Licensed Practical Nurse | 909 S Michael St, Saint Marys, PA 15857-3030 | 2019-07-25 |
| 1477117885 | Kelly Rae Martin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13881 Schuelke Beach Rd Nw, Miltona, MN 56354 | 2019-05-01 |
| 1679098727 | Kelly Lynn Martin | Massage Therapist | 6537 Fairlane Dr, Boston, NY 14025-9637 | 2017-08-10 |
| 1891231379 | Kelly Martin | Speech-Language Pathologist | 3513 Indian Oaks Ln, Toledo, OH 43617-3007 | 2017-01-09 |
| 1376900654 | Kelly Ann Martin | Counselor | 5501 Pandale Valley Dr, Mckinney, TX 75071-7721 | 2016-01-18 |
| 1245616481 | Kelly A Martin | Counselor | 8180 Eagle Mountain Cir, Fort Worth, TX 76135-9531 | 2015-08-10 |
| 1538563077 | Kelly Ann Martin | Counselor | 15208 County Road 1835, Lubbock, TX 79424-8520 | 2014-10-13 |
| 1124430764 | Kelly Michael Martin | Registered Nurse | 1001 S. Gearge St, York, PA 17403 | 2014-06-02 |
| 1205266277 | Kelly Martin | Social Worker | 110 N. Fouth Avenue, Ann Arbor, MI 48107 | 2013-11-12 |
| Street Address |
12111 N 66TH AVE |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85304-1625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386254027 | J & B Assisted Living, Inc. D/b/a J & B Behavioral Health II | Substance Abuse Rehabilitation Facility | 6613 W. Pershing Avenue, Glendale, AZ 85304 | 2020-08-07 |
| 1194214015 | Vema Corporation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4309 W Corrine Dr, Glendale, AZ 85304 | 2018-05-07 |
| 1962929224 | Glendale Surgery Center | Clinic/Center | 11851 North 51st Ave, Suite G, Glendale, AZ 85304 | 2017-08-28 |
| 1073941092 | Megan Lorenzen | Occupational Therapist | 5834 W. Bloomfield Rd., Glendale, AZ 85304 | 2013-10-30 |
| 1396178380 | Danielle Marie Wiles | Registered Nurse | 12901 W. 63rd Avenue, Glendale, AZ 85304 | 2013-08-14 |
| 1780017848 | Pedram Nazari | Pharmacist | 4811 North 83rd Avenue, Glendale, AZ 85304 | 2013-08-13 |
| 1740558022 | Krunal Patel | Obstetrics & Gynecology | 5605 W Eugie Ave Ste 111, Glendale, AZ 85304 | 2011-12-01 |
| 1730499609 | Laura A Truax | Physician Assistant | 11851 N. 51st Ave, Ste F-110, Glendale, AZ 85304 | 2010-10-13 |
| 1760698419 | Suhir Bitar | Pediatrics | 13625 N 59th Ave, Glendale, AZ 85304 | 2007-05-16 |
| 1497967293 | Pam Rubbone | Psychologist | 4650 West Sweetwater Ave., Glendale, AZ 85304 | 2007-05-04 |
| Find all providers in zip 85304 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851803621 | Elizabeth Ramos | Rehabilitation Practitioner | 610 E Acacia Ave, Glendale, CA 91205-3044 | 2017-11-01 |
| 1629592506 | Alfredo Manuel Mercado Jr. | Rehabilitation Practitioner | Tobinworld Mental Health, 920 E Boradway Street, Glendale, CA 91001 | 2017-08-01 |
| 1649715673 | Rosalba Florencio | Rehabilitation Practitioner | 919 E Acacia Ave, #d, Glendale, CA 91205-3027 | 2016-12-29 |
| 1164660098 | Julia Elizabeth Gomez | Rehabilitation Practitioner | 620 E Chevy Chase Dr, Glendale, CA 91205-3014 | 2009-01-30 |
| 1285871103 | Raquel Lemus | Rehabilitation Practitioner | 1132 Ethel St, Glendale, CA 91207-1822 | 2009-01-14 |
| 1013163443 | Cristina Noelle Mardirossian | Rehabilitation Practitioner | 3325 N Verdugo Rd, Glendale, CA 91208-1669 | 2008-08-18 |
| 1346427598 | Marco Mesrobian | Rehabilitation Practitioner | 237 N Central Ave Fl 2, Glendale, CA 91203-2531 | 2008-01-29 |
| 1164455531 | Killeen Therapy Services, Inc | Rehabilitation Practitioner | 19047 N 76th Ave, Glendale, AZ 85308-8304 | 2006-07-09 |
| 1750934279 | Carlos Mina | Rehabilitation Practitioner | 920 E Broadway, Glendale, CA 91205-1204 | 2019-07-23 |
| 1477065563 | Brandi Alexandria Dechellis | Rehabilitation Practitioner | 500 N Central Ave, Glendale, CA 91203-3905 | 2017-10-29 |
| Find all providers in GLENDALE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.