Kevin J Maxwell, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

638 Issued in OK

Practice address

1111 N Lee Ave Ste 105
Oklahoma City, OK 73103-2620

Phone

(405) 600-6730

Fax

(405) 600-6750

NPI assigned

Jul 21, 2008

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Mercy Health Services Inc.

  • Medical Specialty Clinic/Center
  • Yukon, OK
  • NPI 1255398251
  NPD (past)

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1003071952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N LEE AVE STE 105",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731032620",
            "telephone_number": "405-600-6730",
            "fax_number": "405-600-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N LEE AVE STE 105",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731032620",
            "telephone_number": "405-600-6730",
            "fax_number": "405-600-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "KEVIN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baylor Trent Maxwell, DO
• Brian David Maxwell, MD
• Brittany Maxwell
• Jaiden A Maxwell
• Jared F Maxwell
• Rebekah Lea Maxwell, RD
• Scott W Maxwell, M.D.
• Whittnee Renee Maxwell, LPN
• Brittney May, BA OF SCIENCE
• Jennifer Joan May, MSW

• Medical Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.