Active NPI
Robert Maxwell, M.D.
- Pediatrics Physician
- Thomasville, GA
National Provider Identifier
1306275441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 14649
- Practice address
- 213 Pembroke PL
Thomasville, GA 31792-6750 - Phone
- (229) 226-8374
- NPI assigned
- Nov 8, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 14649 | GA | Primary |
Addresses
Primary practice location
213 Pembroke PL
Thomasville, GA 31792-6750
Mailing address
213 Pembroke PL
Thomasville, GA 31792-6750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150309002207 | GA | Order and Referring Only - Pediatric Medicine | 1951627074 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383868800000",
"number": "1306275441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 PEMBROKE PL",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317926750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 PEMBROKE PL",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317926750",
"telephone_number": "229-226-8374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXWELL",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-08",
"last_updated": "2013-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "14649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thomasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.