Individual provider Active NPI

Mark Maddox

  • Internal Medicine Physician
  • Durham, NC
National Provider Identifier
1255744124
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OT016080 Issued in PA
Practice address
508 Fulton St
Durham, NC 27705-3875
Phone
(919) 286-0411
NPI assigned
Jun 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OT016080 PA Primary

Addresses

Primary practice location

508 Fulton St
Durham, NC 27705-3875

Mailing address

508 Fulton St
Durham, NC 27705-3875
Phone (919) 286-0411

Other names 1

  • N/a N/a Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240731003430 NC Practitioner - Medical Oncology 7012213325 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

40 Duke Medicine Cir
Durham, NC 27710-3810
Phone (919) 684-8111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT016080PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince May 12, 2024 Accepting new patients
Duke University Health System, Inc. Internal Medicine CurrentSince Aug 12, 2024 Accepting new patients
Duke University Health System, Inc. CurrentSince Aug 12, 2024 Accepting new patients

Locations

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

Interoperability endpoints

  • Direct secure messaging: mmaddox570070@direct.medicine.duke.edu

Organizations & group practices 3

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

Hospital & facility affiliations 8

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": "1402185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1255744124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-286-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-286-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-08",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT016080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.