Active NPI
Maria Maynard, PHYSICIAN ASSISTANT
- Physician Assistant
- Marietta, OK
National Provider Identifier
1184080145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2598
- Practice address
- 300 Wanda St
Marietta, OK 73448-1200 - Phone
- (580) 276-3347
- NPI assigned
- Jan 6, 2016
- Last updated
- Jan 6, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2598 | OK | Primary |
Addresses
Primary practice location
300 Wanda St
Marietta, OK 73448-1200
Mailing address
300 Wanda St
Marietta, OK 73448-1200
Phone (580) 276-3347
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2598 | OK | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452038400000",
"number": "1184080145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 WANDA ST",
"city": "MARIETTA",
"state": "OK",
"postal_code": "734481200",
"telephone_number": "580-276-3347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 WANDA ST",
"city": "MARIETTA",
"state": "OK",
"postal_code": "734481200",
"telephone_number": "580-276-3347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYNARD",
"first_name": "MARIA",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-06",
"last_updated": "2016-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "2598",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, OK
- Marietta Discount Pharmacy, Inc (Marietta Pharmacy)
- Marietta Family Dentistry
- Marietta Operating Co, LLC (Lake Country Nursing Center)
- Marietta Pharmacy LLC (Marietta Pharmacy)
- Jessica K Marquez
- McIver Vision Clinic
- Ann L. McIver, O.D.
- Mental Health Services of Southern Oklahoma
- Mental Health Services of Southern Oklahoma
- Mercy Health - Love County EMS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.