Active NPI
Deloris Maxwell
- Nurse's Aide
- Monticello, FL
National Provider Identifier
1205269370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- CNA19247
- Practice address
- 385 W Lake Rd
Monticello, FL 32344-5647 - Phone
- (850) 997-0141
- Fax
- (850) 997-1208
- NPI assigned
- Aug 13, 2013
- Last updated
- Aug 13, 2013
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | CNA19247 | FL | Primary |
Addresses
Primary practice location
385 W Lake Rd
Monticello, FL 32344-5647
Mailing address
385 W Lake Rd
Monticello, FL 32344-5647
Phone (850) 997-0141
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 141346500 | Medicaid | FL |
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 |
|---|---|---|---|
| CNA19247 | FL | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376352000000",
"number": "1205269370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "385 W LAKE RD",
"city": "MONTICELLO",
"state": "FL",
"postal_code": "323445647",
"telephone_number": "850-997-0141",
"fax_number": "850-997-1208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "385 W LAKE RD",
"city": "MONTICELLO",
"state": "FL",
"postal_code": "323445647",
"telephone_number": "850-997-0141",
"fax_number": "850-997-1208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXWELL",
"first_name": "DELORIS",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-13",
"last_updated": "2013-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "FL",
"license": "CNA19247",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "141346500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monticello, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.