Michelle Renee Maynard, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

012447 Issued in OH

Practice address

303 N Hurstbourne Pkwy Ste 200
Louisville, KY 40222-5158

Phone

(502) 412-5847

NPI assigned

Nov 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, IN, MI, OH, MA5 enrollments

Enrollment records 5

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Paragon Outpatient Rehabilitation Services, LLC

  dba Synchrony Rehabilitation

  • Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1871867325

  IN, MA, MI, OH, SC

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1285978791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 W MAIN CROSS ST",
            "address_2": "P O BOX 35",
            "city": "MILLER CITY",
            "state": "OH",
            "postal_code": "458640035",
            "telephone_number": "419-876-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N HURSTBOURNE PKWY STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225158",
            "telephone_number": "502-412-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "012447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa G. Mayfield, DMD
• Angela Kay Mayhill, PTA
• Joseph Mayhorn
• Hannah Mayle
• Kristen Maynard
• Paige Renee Maynard, B.S, IECE, TVI
• Staci Beth Maynard, PROVISIONAL TVI
• Tammy Lea Maynard, DI
• Teri L Maynard
• Alice Maynor

• Physical Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.