Paden Jeffrey Maudlin, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

24-01552 Issued in KS

Practice address

811 N Walnut St
Maryville, MO 64468-1353

Phone

(660) 541-0601

NPI assigned

Dec 30, 2016

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1483056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627171200000",
    "number": "1295270171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7933 N FLINTLOCK RD APT H",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641581141",
            "telephone_number": "832-402-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 N WALNUT ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644681353",
            "telephone_number": "660-541-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUDLIN",
        "first_name": "PADEN",
        "middle_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-30",
        "last_updated": "2021-07-25",
        "certification_date": "2021-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-01552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS STATE BOARD OF HEALING ARTS",
            "identifier": "24-01552",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "paden.maudlin@hcahealthcare.com",
            "affiliation": "Y",
            "affiliationName": "Kansas City Gastroenterology & Hepatology,LLC",
            "address_1": "6675 Holmes Rd Ste 430",
            "city": "Kansas City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "641311167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maryville Rehabilitation & Health Care Center LLC
• Mark Masalskis, ATC, LAT
• Robert Cook Mathews, M.D.
• Madelynn Rose Mattson
• Robynn Mattson, CCC-SLP
• Brooke McDonald
• Kathryn McEwen, ATC, LAT
• Jaylee Evonne McGinness, RDH
• Carol L McIntyre, D.O.
• Shane McMillan, PHARMD

• Athletic Trainer in Maryville, MO
• Providers in Maryville, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2021; 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.