Jason Alan Maxwell, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

06005269A Issued in IN

Practice address

7525 Maplecrest Rd # 112
Fort Wayne, IN 46835-1897

Phone

(260) 273-1206

NPI assigned

Oct 30, 2016

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1477785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477785600000",
    "number": "1023560638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 MAPLECREST RD # 112",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468351897",
            "telephone_number": "260-273-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 MAPLECREST RD # 112",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468351897",
            "telephone_number": "260-273-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "JASON",
        "middle_name": "ALAN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-30",
        "last_updated": "2016-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06005269A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Mautz, ATC
• Angela Maver
• Maxcare Bionics Inc
• Maxcare Orthotics and Prosthetics LLC
• Maxim Healthcare Services, Inc.
• Sarah Maxwell, LMHC
• Stacy Maxwell
• Amiah May
• Dawn M May, COTA
• Erica May, ATC, LAT

• Physical Therapy Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physical Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2016; 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.