DR. MICAH DIONISIO MARTINEZ (NPI# 1922585058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922585058 |
| Entity Type | Individual |
| Full Name | DR. MICAH DIONISIO MARTINEZ |
| Credential | MD |
| Practice Address |
1906 Braeburn Dr Salem VA 24153-7304 |
| Mailing Address |
4631 Heather Dr Sw Apt 315 Roanoke VA 24018-7107 |
| Practice Telephone | 5404442359 |
| Mailing Telephone | 8184686846 |
| Enumeration Date | 2018-07-21 |
| Last Update Date | 2019-12-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | VA | Student, Health Care | |
| N | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 66 S San Antonio Rd, Santa Barbara, CA 93110 | 8059475175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508123100 | Micah Martinez | Behavioral Analyst | 224 S Jones Blvd, Las Vegas, NV 89107-2657 | 2012-04-19 |
| Street Address |
1906 BRAEBURN DR |
| City | SALEM |
| State | VA |
| Zip Code | 24153-7304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760460943 | Robert D Moylan | Internal Medicine | 1906 Braeburn Dr, Valley Gastroenterology of Sw Va, Salem, VA 24153 | 2006-01-06 |
| 1477182442 | Ivan Christopher Krpan | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Dr, Salem, VA 24153-7304 | 2020-04-02 |
| 1972131175 | Christy Nicole Blevins | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Dr, Salem, VA 24153-7304 | 2020-04-01 |
| 1275161564 | Gary Aaron Stocker | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Dr, Salem, VA 24153-7304 | 2020-03-31 |
| 1578191722 | Richard Grove Pardo | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Dr, Salem, VA 24153-7304 | 2020-03-31 |
| 1417585852 | Forrest Bodily | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Dr, Salem, VA 24153-7304 | 2020-03-31 |
| 1629606041 | Ahmed Imtiaz | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Dr, Salem, VA 24153-7304 | 2020-03-31 |
| 1801424239 | Daniel Robert Nicholas | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Dr, Salem, VA 24153-7304 | 2020-03-31 |
| 1356683700 | Norah A Silver | Psychiatry & Neurology | 1906 Braeburn Dr, Salem, VA 24153-7304 | 2013-03-25 |
| 1912110404 | Michelle Frieben | Psychiatry & Neurology | 1906 Braeburn Dr, Salem, VA 24153-7304 | 2007-05-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669001228 | Paul Mcguire | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Drive Psychiatry Gme, Salem, VA 24153 | 2020-04-06 |
| 1386114965 | Dynamic Medical LLC | Clinical Medical Laboratory | 1201 Texas Street, Salem, VA 24153 | 2018-11-27 |
| 1134607898 | Renew Psychiatry Services | Psychiatry & Neurology | 177 Electric Rd, Salem, VA 24153 | 2018-08-03 |
| 1508304015 | Samantha Getz | Assisted Living Facility | 3706 Knollridge Rd., Salem, VA 24153 | 2017-02-03 |
| 1518409762 | Melissa Ward | Case Manager/Care Coordinator | 1380 Southside Dr, Suite 100, Salem, VA 24153 | 2016-11-04 |
| 1154729051 | Allison Marie Parry | Physician Assistant | 1336 W Main St., Salem, VA 24153 | 2014-12-09 |
| 1598199457 | Stacy Stanley | Occupational Therapy Assistant | 4812 Moore Rd, Salem, VA 24153 | 2013-08-28 |
| 1366888034 | Dolores Hager | Speech-Language Pathologist | 1851 Harrogate Dr, Salem, VA 24153 | 2013-05-21 |
| 1073850764 | Joel Aaron Nickerson | Specialist/Technologist | 400 Spartan Dr., Salem High School, Salem, VA 24153 | 2013-01-15 |
| 1023387271 | National Diabetic Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 2153 Apperson Drive, Salem, VA 24153 | 2011-12-16 |
| Find all providers in zip 24153 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740899343 | Damien Miller | Student in an Organized Health Care Education/Training Program | 208 Spring Meadow Cir, Salem, IN 47167-9430 | 2020-07-29 |
| 1063039196 | Courtney Amber Allred | Student in an Organized Health Care Education/Training Program | 1764 N Warbler Rd, Salem, UT 84653-5761 | 2020-07-06 |
| 1619591872 | Maryam Cheema | Student in an Organized Health Care Education/Training Program | 1970 Roanoke Blvd Dept Of, Salem, VA 24153-6404 | 2020-06-03 |
| 1669001228 | Paul Mcguire | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Drive Psychiatry Gme, Salem, VA 24153 | 2020-04-06 |
| 1942865001 | Cierra Elizabeth Omlor | Student in an Organized Health Care Education/Training Program | 99 Frog Ocean Rd, Salem, NJ 08079-3451 | 2019-05-04 |
| 1972064343 | Lauren Eary | Student in an Organized Health Care Education/Training Program | 7345 Bradshaw Rd, Salem, VA 24153-2204 | 2019-03-28 |
| 1780172353 | Julie Nguyen | Student in an Organized Health Care Education/Training Program | 61 Barstow St, Salem, MA 01970-2303 | 2018-04-28 |
| 1487163044 | Rachel Amos | Student in an Organized Health Care Education/Training Program | 31731 Carey Rd, Salem, OH 44460-9566 | 2017-09-27 |
| 1710406376 | Karla Angelica Flores Martinez | Student in an Organized Health Care Education/Training Program | 3717 Homestead Rd S, Salem, OR 97302-9753 | 2017-09-14 |
| 1457899734 | Amelia Witter | Student in an Organized Health Care Education/Training Program | 3434 Buckwood Trl, Salem, VA 24153-9035 | 2017-02-07 |
| Find all providers in SALEM | ||||
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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.