Active NPI
Lynn G Maxwell, M.D.
- Pediatric Anesthesiology Physician
- Philadelphia, PA
National Provider Identifier
1164435343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Anesthesiology Physician
- License
- MD419245
- Practice address
- 34TH Street & Civic Center Blvd
Suite 9329
Philadelphia, PA 19104-4399 - Phone
- (215) 590-1858
- Fax
- (215) 590-1415
- NPI assigned
- Aug 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD419245 | PA | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | MD419245 | PA | |
| Pediatric Anesthesiology Physician | 207LP3000X | MD419245 | PA | Primary |
Addresses
Primary practice location
34TH Street & Civic Center Blvd
Suite 9329
Philadelphia, PA 19104-4399
Mailing address
100 E Penn SQ
The Wanamaker Building, 9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 198358EJL | Other | PA | MEDICARE PTAN ANESTHESIA |
| 057804J6Z | Other | PA | MEDICARE PTAN PAIN MANAGEMENT |
| 0016553470 | Medicaid | PA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD419245 | PA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366156800000",
"number": "1164435343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E PENN SQ",
"address_2": "THE WANAMAKER BUILDING, 9TH FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191073323",
"telephone_number": "267-425-9300",
"fax_number": "267-425-9331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34TH STREET & CIVIC CENTER BLVD",
"address_2": "SUITE 9329",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044399",
"telephone_number": "215-590-1858",
"fax_number": "215-590-1415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXWELL",
"first_name": "LYNN",
"middle_name": "G",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-15",
"last_updated": "2013-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "PA",
"license": "MD419245",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "PA",
"license": "MD419245",
"primary": false
},
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "PA",
"license": "MD419245",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN ANESTHESIA",
"identifier": "198358EJL",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN PAIN MANAGEMENT",
"identifier": "057804J6Z",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0016553470",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.