Holt Benjamin Maddux Jr., M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

11107 Issued in TN

Practice address

1325 Wolf Park Dr
Suite 102
Germantown, TN 38138-1742

Phone

(901) 252-3400

Fax

(901) 682-0047

NPI assigned

Apr 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Conrad Pearson Clinic

  • Medical Specialty Clinic/Center
  • Germantown, TN
  • NPI 1174864946
  NPD (past)
• Urlogy Ambulatory Surgery Center LLC

  dba Wolf River Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Germantown, TN
  • NPI 1366422370
  NPD (past)

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275590606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 WOLF PARK DR",
            "address_2": "SUITE 103",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381742",
            "telephone_number": "901-252-3411",
            "fax_number": "901-384-6422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 WOLF PARK DR",
            "address_2": "SUITE 102",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381742",
            "telephone_number": "901-252-3400",
            "fax_number": "901-682-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDUX",
        "first_name": "HOLT",
        "middle_name": "BENJAMIN",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "11107",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MS",
            "license": "16103",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH SERVICES",
            "identifier": "211159",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH LINK",
            "identifier": "115806",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "12940170",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ASSURANCE EPA",
            "identifier": "12940170",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3007327",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AR",
            "identifier": "85552",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0063189",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUAL CHOICE",
            "identifier": "02110025300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4563452",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2596090",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "731661",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• M Nan Hawkes PHD Med Psych Group
• Edward H Mabry Jr., MD
• Kempton Brock Macleod, RN
• Abdul-Hamid Madamidola
• Louis Alonzo Madden, ATC
• Madonna Learning Center
• Daniel Lee Magro Jr., M.D.
• Christine Mahoney
• Nora Elizabeth Maldonado, M.D.
• Maram Mallisho, MD

• Urology Physician in Germantown, TN
• Providers in Germantown, TN by specialty
• Urology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.