Patrick Neal Maddy, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

5119 Issued in KY

Practice address

3070 11TH Ave Dr SE
Hickory, NC 28602

Phone

(828) 695-5776

Fax

(828) 695-2101

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1245307867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 MOSTELLER ESTATE AVE SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "28602",
            "telephone_number": "828-638-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 11TH AVE DR SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "28602",
            "telephone_number": "828-695-5776",
            "fax_number": "828-695-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDY",
        "first_name": "PATRICK",
        "middle_name": "NEAL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "5119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909251",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60051190",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• October Evans Makabin, LCSW(A)-1041C0700X
• Russell A. Makant, LCMHCA

• Dentist in Hickory, NC
• Providers in Hickory, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.

Verify at the official NPI Registry.