NPIMap

Organization Active NPI

James Stephen Maddox

  • Dermatology Physician
  • Montgomery, AL
National Provider Identifier
1306902127
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
10825 Issued in AL
Legal business name
JAMES STEPHEN MADDOX
Doing business as
Dermatology Associates
Practice address
286 Mitylene Park Dr
Montgomery, AL 36117
Phone
(334) 396-1555
Fax
(334) 396-9833
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Authorized official

Name
Carolyn Stone Barrett
Title
Office Manager
Phone
(334) 396-1555

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X 10825 AL Primary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X 00009695 AL

Addresses

Primary practice location

286 Mitylene Park Dr
Montgomery, AL 36117

Mailing address

PO Box 241627
Montgomery, AL 36124-1627
Phone (334) 396-1555

Other identifiers 3

IdentifierTypeStateIssuer
528501290MedicaidAL
511-30216OtherALBCBS
CM4358OtherALRR MCR

Other names 1

  • Dermatology Associates Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1306902127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241627",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361241627",
            "telephone_number": "334-396-1555",
            "fax_number": "334-396-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 MITYLENE PARK DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36117",
            "telephone_number": "334-396-1555",
            "fax_number": "334-396-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES STEPHEN MADDOX",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "STONE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "334-396-1555"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "AL",
            "license": "10825",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "AL",
            "license": "00009695",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528501290",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "511-30216",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "CM4358",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.