NPIMap

Organization Active NPI

Maxim Healthcare Services, Inc.

  • Home Health Agency
  • Beaumont, TX
National Provider Identifier
1225060213
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
8860 Issued in TX
Legal business name
MAXIM HEALTHCARE SERVICES, INC.
Practice address
350 Pine St Ste 1430
Beaumont, TX 77701-2441
Phone
(409) 833-4004
Fax
(409) 833-4050
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Authorized official

Name
David Kowalczyk
Title
Controller
Phone
(410) 910-1500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 8860 TX Primary
Nursing Care Agency 251J00000X

Addresses

Primary practice location

350 Pine St Ste 1430
Beaumont, TX 77701-2441

Mailing address

7227 Lee Deforest Drive
Columbia, MD 21046-3405
Phone (410) 910-1500

Other identifiers 1

IdentifierTypeStateIssuer
001012435MedicaidTX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1014915Maxim Healthcare Services, Inc350 Pine Street, Suite 1430, Beaumont, TX 77701Certificate of waiverJul 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Maxim Healthcare Servise337 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 9

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

350 Pine St
Ste 1430
Beaumont, TX 77701
Phone (409) 833-4004

350 Pine St
Ste 335
Beaumont, TX 77701
Phone (409) 751-2100

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1225060213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 LEE DEFOREST DRIVE",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463405",
            "telephone_number": "410-910-1500",
            "fax_number": "410-910-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 PINE ST STE 1430",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777012441",
            "telephone_number": "409-833-4004",
            "fax_number": "409-833-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "410-910-1500"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "8860",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001012435",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.