Individual provider Active NPI

Ryan Peyton Maddox, MD

  • Family Medicine Physician
  • Paragould, AR
National Provider Identifier
1104405422
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-16646 Issued in AR
Practice address
4000 Linwood Dr Ste a
Paragould, AR 72450-7224
Phone
(870) 239-8503
NPI assigned
Apr 5, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-16646 AR Primary

Addresses

Primary practice location

4000 Linwood Dr Ste a
Paragould, AR 72450-7224

Mailing address

4000 Linwood Dr Ste a
Paragould, AR 72450-7224
Phone (870) 239-8503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20240606001396 AR Practitioner - Family Practice 5698179745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Health Group, Inc 23 clinicians

Practice addresses (Care Compare)

4000 Linwood Dr
Suite a
Paragould, AR 72450-7224
Phone (870) 239-8503

4000 Linwood Dr
Suite a
Paragould, AR 72450-8894

Hospital & facility affiliations

  • Ar Meth Med Ctr HH Home health agency, Paragould, AR, CCN 047004
  • St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020
  • Arkansas Methodist Medical Center Hospital, Paragould, AR, CCN 040039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-16646ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Health Group, Inc CurrentSince Jul 22, 2024 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients
Doctors Health Group, Inc Family Medicine CurrentSince Jul 22, 2024 Accepting new patients

Locations

4000 Linwood Dr
Ste A
Paragould, AR 72450
Phone (870) 239-8503

Interoperability endpoints

  • Direct secure messaging: rpmaddox@sbpc.medalliesdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1104405422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 LINWOOD DR STE A",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724507224",
            "telephone_number": "870-239-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 LINWOOD DR STE A",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724507224",
            "telephone_number": "870-239-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "RYAN",
        "middle_name": "PEYTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-16646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paragould, AR

Sources for this page

Verify at the official NPI Registry.