Individual provider Active NPI

Carmen P Maddocks, NP-C

  • Family Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1124302039
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP4234 Issued in AZ
Practice address
1400 N Gilbert Rd Ste 1
Gilbert, AZ 85234-2328
Phone
(623) 977-2707
NPI assigned
Oct 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP4234 AZ Primary

Addresses

Primary practice location

1400 N Gilbert Rd Ste 1
Gilbert, AZ 85234-2328

Mailing address

7558 W Thunderbird Rd Ste 1-496
Peoria, AZ 85381-6080
Phone (623) 977-2707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP4234AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nca Holdings of Arizona LLC Past Accepting new patients
Nca Holdings of Arizona, LLC Past Accepting new patients

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": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1124302039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7558 W THUNDERBIRD RD STE 1-496",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853816080",
            "telephone_number": "623-977-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N GILBERT RD STE 1",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342328",
            "telephone_number": "623-977-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOCKS",
        "first_name": "CARMEN",
        "middle_name": "P",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.