Individual provider Active NPI

Walter Clinton Maxcey, APRN-CNP

  • Family Nurse Practitioner
  • Ada, OK
National Provider Identifier
1265943476
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
120518 Issued in OK
Practice address
1601 N Broadway Ave
Ada, OK 74820-1403
Phone
(580) 421-7850
Fax
(580) 421-7855
NPI assigned
Oct 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 120518 OK Primary

Addresses

Primary practice location

1601 N Broadway Ave
Ada, OK 74820-1403

Mailing address

1601 N Broadway Ave
Ada, OK 74820-1403
Phone (580) 421-7850

Other practice location 1

531 E Washington Ave
McAlester, OK 74501-4761
Phone (918) 470-3926

Other practice location 2

400 NE 12th St
Guymon, OK 73942-3655
Phone (580) 338-2637

Other practice location 3

400 NE 12th St
Guymon, OK 73942-3655
Phone (580) 338-2637

Other practice location 4

531 E Washington Ave
McAlester, OK 74501-4761
Phone (918) 470-3926

Other identifiers 1

IdentifierTypeStateIssuer
200744650AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180122000270 OK Practitioner - Nurse Practitioner 4880953892 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McAlester Medical Services LLCGroup PAC ID 9931139029, 21 clinicians

Practice addresses (Care Compare)

1 E Clark Bass Blvd
McAlester, OK 74501-4209
Phone (918) 421-6987

111 W Forrest Ave B
Eufaula UC
Eufaula, OK 74432-3205
Phone (918) 490-7011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McAlester Regional Health Center Authority CurrentSince Aug 2, 2021 Accepting new patients
McAlester Medical Services, LLC CurrentSince Oct 1, 2020 Accepting new patients
Panhandle Womens Center P L L C Past Accepting new patients
McAlester Regional Health Center Authority Past Accepting new patients
Eagle Partners, PLLC PastSince Oct 1, 2020 Accepting new patients

Locations

111 W Forrest Ave
Ste B
Eufaula, OK 74432
Phone (918) 490-7011

1 Hospital Dr
Eufaula, OK 74432
Phone (918) 689-2535

1 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6941

10 S 3rd St
McAlester, OK 74501
Phone (918) 382-3178

4 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6700

Interoperability endpoints

  • Direct secure messaging: walter.maxcey@direct.mrhcok.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1507939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521417600000",
    "number": "1265943476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N BROADWAY AVE",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748201403",
            "telephone_number": "580-421-7850",
            "fax_number": "580-421-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N BROADWAY AVE",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748201403",
            "telephone_number": "580-421-7850",
            "fax_number": "580-421-7855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "531 E Washington Ave",
            "address_purpose": "LOCATION",
            "city": "McAlester",
            "state": "OK",
            "postal_code": "745014761",
            "country_code": "US",
            "telephone_number": "918-470-3926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 NE 12th St",
            "address_purpose": "LOCATION",
            "city": "Guymon",
            "state": "OK",
            "postal_code": "739423655",
            "country_code": "US",
            "telephone_number": "580-338-2637",
            "fax_number": "580-338-2652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 NE 12th St",
            "address_purpose": "LOCATION",
            "city": "Guymon",
            "state": "OK",
            "postal_code": "739423655",
            "country_code": "US",
            "telephone_number": "580-338-2637",
            "fax_number": "580-338-2652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "531 E Washington Ave",
            "address_purpose": "LOCATION",
            "city": "McAlester",
            "state": "OK",
            "postal_code": "745014761",
            "country_code": "US",
            "telephone_number": "918-470-3926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAXCEY",
        "first_name": "WALTER",
        "middle_name": "CLINTON",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-14",
        "last_updated": "2018-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "120518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200744650A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.