Cody Maxwell

Primary specialty

PharmacistTaxonomy code 183500000X

License

22913 Issued in IA

Practice address

757 W Broadway
Council Bluffs, IA 51501-4197

Phone

(712) 328-3277

Fax

(712) 325-1469

NPI assigned

Mar 10, 2020

Last updated

Mar 10, 2020By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hy-Vee Inc

  dba Hy-Vee Pharmacy (#1876)

  • Community/Retail Pharmacy
  • Wausau, WI
  • NPI 1396619839
  NPD (past)

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1265067292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 W BROADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515014197",
            "telephone_number": "712-328-3277",
            "fax_number": "712-325-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 W BROADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515014197",
            "telephone_number": "712-328-3277",
            "fax_number": "712-325-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "CODY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "22913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.hy-vee.com/stores/Detail.aspx?s=197",
            "affiliation": "N",
            "address_1": "757 W Broadway",
            "city": "Council Bluffs",
            "state": "IA",
            "country_code": "US",
            "postal_code": "515014197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeffrey Bernard Mathiasen
• Richard Oliver Matland, MSW, LISW
• Rebecca Max
• Andrew Maxwell, M.D.
• Barbara Lynn Maxwell, LMSW
• Kristin M. Maxwell, PA-C
• Riley Kay Maxwell
• May Medical, Inc.
• Susan Dawn Mayberry
• Latois Nicole Mayfield

• Pharmacist in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Pharmacist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.