Individual provider Active NPI

Maximilian Simpson, HIS

  • Hearing Instrument Specialist
  • Jackson, OH
National Provider Identifier
1366138422
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
1110 Issued in WV
Practice address
765 East Main Street
Jackson, OH 45640-2130
Phone
(740) 286-3656
Fax
(513) 332-9072
NPI assigned
Apr 12, 2023
Last updated
Dec 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X NU
Hearing Instrument Specialist 237700000X 292456 KY
Hearing Instrument Specialist 237700000X IL.03521 OH
Hearing Instrument Specialist 237700000X 1110 WV Primary

Addresses

Primary practice location

765 East Main Street
Jackson, OH 45640-2130

Mailing address

600 6TH Avenue
Huntington, WV 25701-2104
Phone (304) 521-4365

Other practice location 1

28 Cedar St
Gallipolis, OH 45631-1211
Phone (740) 446-1744

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1110WVMDCounselor
292456KYMDHearing Instrument Specialist
IL.03521OHMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
H William Mattingly Corporation Hearing Instrument Specialist CurrentSince Nov 10, 2024 Accepting new patients

Locations

600 6th Ave
Huntington, WV 25701
Phone (304) 521-1663

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1366138422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 6TH AVENUE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257012104",
            "telephone_number": "304-521-4365",
            "fax_number": "513-332-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 EAST MAIN STREET",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456402130",
            "telephone_number": "740-286-3656",
            "fax_number": "513-332-9072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 Cedar St",
            "address_purpose": "LOCATION",
            "city": "Gallipolis",
            "state": "OH",
            "postal_code": "456311211",
            "country_code": "US",
            "telephone_number": "740-446-1744",
            "fax_number": "521-332-9072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "MAXIMILIAN",
        "name_prefix": "Mr.",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-12",
        "last_updated": "2024-12-03",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "KY",
            "license": "292456",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "OH",
            "license": "IL.03521",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "WV",
            "license": "1110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.