Active NPI
Mark Curry Maynard, FNP
- Nurse Practitioner
- Advance, NC
National Provider Identifier
1104339084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5010267
- Practice address
- 125 W Robin Dr
Advance, NC 27006 - Phone
- (336) 529-0281
- NPI assigned
- Nov 14, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 245287 | NC | |
| Nurse Practitioner | 363L00000X | 5010267 | NC | Primary |
Addresses
Primary practice location
125 W Robin Dr
Advance, NC 27006
Mailing address
PO Box 751803
Charlotte, NC 28275-1803
Other practice location 1
125 W Robin Dr
Advance, NC 27006-7926
Phone (336) 529-0281
Other practice location 2
125 W Robin Dr
Advance, NC 27006-7926
Phone (336) 529-0281
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mmaynard143743@direct.novanthealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
317 Western Blvd
Jacksonville, NC 28546-6338
Phone (910) 577-2345
Hospital & facility affiliations
- Onslow Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5010267 | NC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Onslow Memorial Hospital Inc | Current | Accepting new patients | |
| Tarheel Emergency Group, PLLC | Current | Accepting new patients | |
| Emergency Coverage Services, PC | Nurse Practitioner | Current | Accepting new patients |
Locations
317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240
2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199
615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699
Interoperability endpoints
- mmaynard143743@direct.novanthealth.org
- https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Jacksonville, NC
- NPI 1386388874
-
- General Acute Care Hospital
- Jacksonville, NC
- NPI 1679535496
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jacksonville, NC
- NPI 1679535496
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1104339084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751803",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 W ROBIN DR",
"city": "ADVANCE",
"state": "NC",
"postal_code": "27006",
"telephone_number": "336-529-0281"
}
],
"practiceLocations": [
{
"address_1": "125 W Robin Dr",
"address_purpose": "LOCATION",
"city": "Advance",
"state": "NC",
"postal_code": "270067926",
"country_code": "US",
"telephone_number": "336-529-0281",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "125 W Robin Dr",
"address_purpose": "LOCATION",
"city": "Advance",
"state": "NC",
"postal_code": "270067926",
"country_code": "US",
"telephone_number": "336-529-0281",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAYNARD",
"first_name": "MARK",
"middle_name": "CURRY",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-14",
"last_updated": "2020-10-26",
"certification_date": "2020-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "NC",
"license": "245287",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5010267",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mmaynard143743@direct.novanthealth.org",
"affiliation": "N",
"address_1": "125 W Robin Dr",
"city": "Advance",
"state": "NC",
"country_code": "US",
"postal_code": "270067926",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Advance, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.