Michaela Ann Maynard, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

CAPRN01596 Issued in RI

Practice address

1125 N Main St
Providence, RI 02904-5739

Phone

(401) 793-2928

NPI assigned

Aug 4, 2015

Last updated

Nov 27, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Yale University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Rhode Island Public Health FoundationGroup PAC ID 7810324597, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20649/brand/1/csg/1/fhir/r4
• Direct secure messaging: michaela.maynard.1@20649.direct.athenahealth.com

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.

• The Rhode Island Public Health Foundation

  dba Open Door Health

  • Clinic/Center
  • Providence, RI
  • NPI 1669024329
  Medicare reassignment Care Compare group NPD
• Lifespan Physician Group, Inc.

  dba Brown Health Medical Group

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment NPD
• Rhode Island Hospital

  • Multi-Specialty Clinic/Center
  • Providence, RI
  • NPI 1154537520
  Medicare reassignment NPD
• The Miriam Hospital

  • Medical Specialty Clinic/Center
  • Providence, RI
  • NPI 1275810434
  Medicare reassignment NPD
• Lifespan Physician Group, Inc.

  dba Brown Health Medical Group

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1972768174
  NPD

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1083090849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045739",
            "telephone_number": "401-793-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045739",
            "telephone_number": "401-793-2928"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Corliss St Ste E2",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029042602",
            "country_code": "US",
            "telephone_number": "401-793-2928",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "180 Corliss St Ste E1",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029042602",
            "country_code": "US",
            "telephone_number": "401-793-2928",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "180 Corliss St Ste F",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029042602",
            "country_code": "US",
            "telephone_number": "401-793-4715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "MICHAELA",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2302797",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "RI",
            "license": "CAPRN01596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly C Mayer, OTR/L
• Kenneth H Mayer, M.D.
• Laura Ashley Mayer, MD
• William Thor Mayleben
• Carlee A. Maynard, NP
• Julia P Mayne, MD
• Sally L Mayo, PHD
• Kiran A Maypole
• Phina A Mayu, NP
• Aidan Mazagonwalla

• Adult Health Nurse Practitioner in Providence, RI
• Providers in Providence, RI by specialty
• Adult Health Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.