Individual provider Active NPI

Daniel Davis Maxwell, MD

  • Specialist
  • Potomac Falls, VA
National Provider Identifier
1073738142
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101024028 Issued in VA
Practice address
20265 Water Mark PL
Potomac Falls, VA 20165-5134
Phone
(703) 404-3729
NPI assigned
Apr 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101024028 VA Primary

Addresses

Primary practice location

20265 Water Mark PL
Potomac Falls, VA 20165-5134

Mailing address

20265 Water Mark PL
Potomac Falls, VA 20165-5134
Phone (703) 404-3729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191218000623 WV Practitioner - Diagnostic Radiology 3678653748 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Virtual Radiologic Professionals, LLC CurrentSince Nov 1, 2022 Accepting new patients

Locations

306 Stanaford Rd
Beckley, WV 25801
Phone (304) 255-3373

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073738142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20265 WATER MARK PL",
            "city": "POTOMAC FALLS",
            "state": "VA",
            "postal_code": "201655134",
            "telephone_number": "703-404-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20265 WATER MARK PL",
            "city": "POTOMAC FALLS",
            "state": "VA",
            "postal_code": "201655134",
            "telephone_number": "703-404-3729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "DANIEL",
        "middle_name": "DAVIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101024028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac Falls, VA

Sources for this page

Verify at the official NPI Registry.