NPIMap

Individual provider Active NPI

Jeremiah J Maddox, MD

  • Orthopaedic Surgery Physician
  • Dothan, AL
National Provider Identifier
1245449800
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
27935 Issued in AL
Practice address
1500 Ross Clark Cir
Dothan, AL 36301-4754
Phone
(334) 793-2663
Fax
(334) 836-2248
NPI assigned
May 21, 2007
Last updated
Nov 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 27935 AL Primary

Addresses

Primary practice location

1500 Ross Clark Cir
Dothan, AL 36301-4754

Mailing address

PO Box 729
Dothan, AL 36302-0729
Phone (334) 793-2663

Other identifiers 7

IdentifierTypeStateIssuer
003112729AMedicaidGA
1245449800OtherALMEDICARE ID
130085MedicaidAL
003112729BMedicaidGA
511-17847OtherALBCBS OF AL - RCC
130087MedicaidAL
511-18371OtherALBCBS OF AL - HEALTHWEST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110906000068 AL Practitioner - Orthopedic Surgery 5890827273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Alabama School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
S.B.J.S. PCGroup PAC ID 8527043421, 39 clinicians

Practice addresses (Care Compare)

1500 Ross Clark Cir
Dothan, AL 36301-4754
Phone (334) 793-2663

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion173
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Laminectomy or laminotomy (partial removal of spine bones)58
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27935ALMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SBJS PC Orthopaedic Surgery CurrentSince Aug 1, 2011 Accepting new patients
S.B.J.S. PC Orthopaedic Surgery CurrentSince Aug 1, 2011 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
S.B.J.S. PC Orthopaedic Surgery Past Accepting new patients
Triad of Alabama LLC Past Accepting new patients

Locations

1500 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-2663

345 Healthwest Dr
Dothan, AL 36303
Phone (334) 793-2663

820 W Washington St
Eufaula, AL 36027
Phone (334) 687-5761

2126 W Roy Parker Rd
Ste 201
Ozark, AL 36360
Phone (334) 445-2663

Interoperability endpoints

  • Direct secure messaging: jeremiah.maddox.1@15455.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1245449800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363020729",
            "telephone_number": "334-793-2663",
            "fax_number": "334-836-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014754",
            "telephone_number": "334-793-2663",
            "fax_number": "334-836-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "JEREMIAH",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AL",
            "license": "27935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003112729A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "1245449800",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130085",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003112729B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL - RCC",
            "identifier": "511-17847",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130087",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL - HEALTHWEST",
            "identifier": "511-18371",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.