Active NPI
Craig Edward Maddox
- Occupational Therapist
- Rutland, VT
National Provider Identifier
1154616407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 072.0078254
- Practice address
- 46 Nichols St
Rutland, VT 05701-3275 - Phone
- (802) 775-2941
- NPI assigned
- Jun 15, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 072.0078254 | VT | Primary |
Addresses
Primary practice location
46 Nichols St
Rutland, VT 05701-3275
Mailing address
21 Woodsworth Close
Red Deer, ALBERTA T4N 5L9
CA
Phone (530) 320-9864
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 072.0078254 | VT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308096000000",
"number": "1154616407",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "21 WOODSWORTH CLOSE",
"city": "RED DEER",
"state": "ALBERTA",
"postal_code": "T4N 5L9",
"telephone_number": "530-320-9864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 NICHOLS ST",
"city": "RUTLAND",
"state": "VT",
"postal_code": "057013275",
"telephone_number": "802-775-2941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDOX",
"first_name": "CRAIG",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-15",
"last_updated": "2011-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VT",
"license": "072.0078254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rutland, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.