Active NPI
Mike D. Maddox, DC, CCST
- Chiropractor
- Austin, TX
National Provider Identifier
1356423560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4162DC
- Practice address
- 500 Canyon Ridge Drive
Suite 200 F
Austin, TX 78753-1659 - Phone
- (512) 339-6565
- Fax
- (512) 339-9248
- NPI assigned
- Oct 19, 2006
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4162DC | TX | Primary |
Addresses
Primary practice location
500 Canyon Ridge Drive
Suite 200 F
Austin, TX 78753-1659
Mailing address
500 Canyon Ridge Drive
Suite 200 F
Austin, TX 78753-1659
Phone (512) 339-6565
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4162DC | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404172800000",
"number": "1356423560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 CANYON RIDGE DRIVE",
"address_2": "SUITE 200 F",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787531659",
"telephone_number": "512-339-6565",
"fax_number": "512-339-9248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 CANYON RIDGE DRIVE",
"address_2": "SUITE 200 F",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787531659",
"telephone_number": "512-339-6565",
"fax_number": "512-339-9248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDOX",
"first_name": "MIKE",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "DC, CCST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2014-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "4162DC",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.