Andrew Maddox

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT014006 Issued in GA

Practice address

9152 Highway 278 NE
Covington, GA 30014-7010

Phone

(678) 342-9339

NPI assigned

Jun 11, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: andmaddox@selectmedical.com

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665792000000",
    "number": "1164081220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5257 HEARTHSTONE ST",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833605",
            "telephone_number": "678-713-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9152 HIGHWAY 278 NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300147010",
            "telephone_number": "678-342-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2022-10-15",
        "certification_date": "2022-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AndMaddox@selectmedical.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "9152 Highway 278 NE",
            "city": "Covington",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300147010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Margaret Blanche Lyons, FNP
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• Candra Lanette Mack, M.D.
• Justin K Mack, DDS
• Macmillz Mobile Medi Assessments LLC
• Made New Counseling, LLC
• Made New Counseling, LLC
• Sabrina Madison, BSN, RN
• Karla Magnes, PHARM D
• Malibu Health Care Agency, Inc,

• Physical Therapist in Covington, GA
• Providers in Covington, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2022; 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.