Active NPI
Janet Willoughby Maynard, M.D.
- Internal Medicine Physician
- Baltimore, MD
National Provider Identifier
1043425812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- D71282
- Practice address
- 5200 Eastern Ave
Mason F. Lord Building Center Tower, Suite 4100
Baltimore, MD 21224-2734 - Phone
- (410) 614-3368
- Fax
- (410) 550-2072
- NPI assigned
- May 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 122414 | NC | |
| Internal Medicine Physician | 207R00000X | D71282 | MD | Primary |
Addresses
Primary practice location
5200 Eastern Ave
Mason F. Lord Building Center Tower, Suite 4100
Baltimore, MD 21224-2734
Mailing address
PO Box 64264
Baltimore, MD 21264-4264
Phone (410) 558-5238
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036817200 | Medicaid | MD | |
| 3400030 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122414 | NC | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307664000000",
"number": "1043425812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 64264",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212644264",
"telephone_number": "410-558-5238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 EASTERN AVE",
"address_2": "MASON F. LORD BUILDING CENTER TOWER, SUITE 4100",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212242734",
"telephone_number": "410-614-3368",
"fax_number": "410-550-2072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYNARD",
"first_name": "JANET",
"middle_name": "WILLOUGHBY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-14",
"last_updated": "2011-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "122414",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D71282",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036817200",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3400030",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.