Individual provider Active NPI

John Dylan Maxie, D.C.

  • Chiropractor
  • Mount Vernon, KY
National Provider Identifier
1003746041
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
299058 Issued in KY
Practice address
111 Progress Dr Ste 400
Mount Vernon, KY 40456-8590
Phone
(859) 236-5562
Fax
(859) 236-5564
NPI assigned
May 21, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 299058 KY Primary

Addresses

Primary practice location

111 Progress Dr Ste 400
Mount Vernon, KY 40456-8590

Mailing address

1420 Hustonville Rd
Danville, KY 40422-2424
Phone (859) 236-5562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260625001406 KY Practitioner - Chiropractic 5799258307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1420 Hustonville Rd
Danville, KY 40422-2424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
299058KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Basics Chiropractic, LLC Chiropractor CurrentSince May 21, 2026 Accepting new patients

Locations

1420 Hustonville Rd
Danville, KY 40422
Phone (859) 236-5562

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": "1779321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1003746041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 HUSTONVILLE RD",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404222424",
            "telephone_number": "859-236-5562",
            "fax_number": "859-236-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 PROGRESS DR STE 400",
            "city": "MOUNT VERNON",
            "state": "KY",
            "postal_code": "404568590",
            "telephone_number": "859-236-5562",
            "fax_number": "859-236-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXIE",
        "first_name": "JOHN",
        "middle_name": "DYLAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-21",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "299058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.