Maxwell Nutrition

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

MAXWELL NUTRITION

Practice address

3101 American Legion Rd Ste 23
Chesapeake, VA 23321-5655

Phone

(757) 589-4293

NPI assigned

Oct 13, 2022

Organization subpart

No

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

Authorized official

Name

Jean MaxwellNPI 1609929108

Title

Owner

Phone

(757) 589-4293

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 2

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

• Jean L Maxwell, MS RD

  • Registered Dietitian
  • Norfolk, VA
  • NPI 1609929108

  Dietitian, Registered

  Medicare reassignment NPD Authorized official
• Jessica Lynn Edmonds, RDN

  • Registered Dietitian
  • Virginia Beach, VA
  • NPI 1043928864

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1063138808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 LONGSTREET LN",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234379621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 AMERICAN LEGION RD STE 23",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215655",
            "telephone_number": "757-589-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXWELL NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-589-4293"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.maxwellnutritionsuffolk.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "3101 American Legion Rd Ste 23",
            "city": "Chesapeake",
            "state": "VA",
            "country_code": "US",
            "postal_code": "233215655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melissa A Matthews, NP
• Emily B Mattison, PT
• Charlotte Moore Maull
• Thomas Lawson Mauser, D.O.
• Ellis Franklin Maxey Jr., MD
• Curt Maxwell, LDO
• Robert Maxwell, RPH
• Lisa Mayes, MSN, APRN, PMHNP-BC
• Bonna Pearl Maynigo, NP
• Karen Maynor, RBT, BCABA, LABA

• Registered Dietitian in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Registered Dietitian in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.