NPIMap

Organization Active NPI

Maxton Agency LLC

  • Early Intervention Provider Agency
  • Blaine, MN
National Provider Identifier
1013795574
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
MAXTON AGENCY LLC
Practice address
1120 112TH LN NE
Blaine, MN 55434-4547
Phone
(612) 735-1096
NPI assigned
Sep 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Authorized official

Name
Esther O IdowuNPI 1992580278
Title
President
Phone
(612) 735-1096

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

1120 112TH LN NE
Blaine, MN 55434-4547

Mailing address

1120 112TH LN NE
Blaine, MN 55434-4547
Phone (612) 735-1096

National Provider Directory

National Provider Directory
Tax ID family
Maxton Agency LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1013795574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 112TH LN NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344547",
            "telephone_number": "612-735-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 112TH LN NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344547",
            "telephone_number": "612-735-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXTON AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-17",
        "status": "A",
        "authorized_official_last_name": "IDOWU",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-735-1096"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.