Active NPI
Max Ronald Rexroat, DPM
- Podiatrist
- Macomb, IL
National Provider Identifier
1235122623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- Practice address
- 437 E Grant St
Macomb, IL 61455 - Phone
- (309) 837-3964
- Fax
- (309) 837-3966
- NPI assigned
- Aug 31, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | IL | Primary |
Addresses
Primary practice location
437 E Grant St
Macomb, IL 61455
Mailing address
437 E Grant St
Macomb, IL 61455
Phone (309) 837-3964
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235122623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "437 E GRANT ST",
"city": "MACOMB",
"state": "IL",
"postal_code": "61455",
"telephone_number": "309-837-3964",
"fax_number": "309-837-3966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "437 E GRANT ST",
"city": "MACOMB",
"state": "IL",
"postal_code": "61455",
"telephone_number": "309-837-3964",
"fax_number": "309-837-3966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REXROAT",
"first_name": "MAX",
"middle_name": "RONALD",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macomb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.