Ralph Martin Maxwell, DO
Individual provider Active NPI Family Medicine Physician · Dumas, AR
NPI 1295722668 · NPPES record last updated Dec 20, 2011
Key facts
- NPI
- 1295722668
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 00356 (ID)
- Practice address
- 811 Highway 65 S
Dumas, AR 71639-3006 - Phone
- (870) 382-8261
- Fax
- (870) 382-8140
- NPI assigned
- Sep 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 14
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dewitt Hospital and Nursing Home Inc
Practice addresses (Care Compare)
1641 S Whitehead Dr
De Witt, AR 72042-2994
Phone (870) 946-3571
Hospital & facility affiliations
- Jefferson Homecare
- Dewitt Hospital & Nursing Home, Inc
- Crestpark Dewitt, LLC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040623001424 | AR | Practitioner - General Practice |
4082699889 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00356 | ID | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dewitt Hospital & Nursing Home, Inc. | Current |
Accepting new patients | |
| Delta Memorial Hospital | Current |
Accepting new patients | |
| Delta Memorial Hospital | Current | Accepting new patients | |
| Delta Memorial Hospital | Current |
Accepting new patients | |
| Stuttgart Regional Medical Center | Past | Accepting new patients | |
| Nes Arkansas, Inc. | Past | Accepting new patients | |
| Premier Emergency Physicians of Idaho Medical Group | Past | Accepting new patients | |
| Stuttgart Regional Medical Center | Past | Accepting new patients | |
| Delta Counseling Associates Inc | Past |
Accepting new patients | |
| Van Buren Hma Inc | Past | Accepting new patients | |
| Nes Western Arkansas, Inc | Past | Accepting new patients | |
| Arkansas Health Group | Family Medicine | Past | Accepting new patients |
| Phillips Landing Emergency Physicians LLC | Past | Accepting new patients |
Locations
1641 S Whitehead Dr
Dewitt, AR 72042
Phone (870) 946-2971
811 Highway 65 S
Dumas, AR 71639
Phone (870) 382-4303
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/deltamh-91f47cd8
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 00356 | ID | Yes |
Addresses
Primary practice location
811 Highway 65 S
Dumas, AR 71639-3006
Mailing address
811 Highway 65 S
PO Box 830
Dumas, AR 71639-3006
Phone (870) 382-8261
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0194584 | Other | WA | DEPT OF LABOR & INDUSTRY |
| S5494 | Other | ID | BLUE CROSS OF ID |
| 807073500 | Medicaid | ID | |
| 000010149459 | Other | ID | REGENCE BS OF ID |
| 8434870 | Medicaid | WA | |
| P00192008 | Other | RAILROAD MEDICARE |
Other providers in Dumas, AR
- Shamim A Malik
- Melissa Mankin
- Marillac Community Health Centers
- Maxus
- Maxus Inc.
- Tironeka McGehee
- Aleshal McIntyre
- Anna Marie Minor
- Carol Mitchell
- Kimberly Mitchell
All providers in Dumas, AR · Family Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.