Maxim Healthcare Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

R2391 Issued in MD

Legal business name

MAXIM HEALTHCARE SERVICES, INC.

Practice address

1120 Benfield Blvd Ste a-B
Millersville, MD 21108-2528

Phone

(443) 274-3071

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

David Kowalczyk

Title

VP of Finance

Phone

(410) 910-1500

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Home health agency certification: CCN 157679

Legal name

MAXIM HEALTHCARE SERVICES INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 8, 2015

Last certification

Sep 16, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Sep 2, 1988 in MD

Enrollment address

5265 Commerce Blvd
Ste E
Crown Point, IN 46307-5327
HHA Branch

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Maxim Healthcare Services, Inc.

  • Home Health Agency
  • Crown Point, IN
  • NPI 1760586937

  O20140710000259

  Same enrollment

Listed as

Maxim Healthcare Services IncCCN 157679

Ownership

Proprietary

Certified

Jun 8, 2015

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide

Locations

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1306957824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 LEE DEFOREST DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 BENFIELD BLVD STE A-B",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211082528",
            "telephone_number": "443-274-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "410-910-1500"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MD",
            "license": "R2391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413683700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0166-DL5812",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5550432-04",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iman Kimm Massey
• Markeita Matthews, LCSW-C
• Suzanne Matty, LCSW-C
• Marylis Maturana
• Erinn E Maury, MD
• Christine Maynard, LMSW
• McCarl Dental Group PC
• Allison McClare, LMT
• Susan McClare, LMT, MMP
• Sania Katherine McClure

• Home Health Agency in Millersville, MD
• Providers in Millersville, MD by specialty
• Home Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.