Active NPI
Dominique Maywald
- Social Worker
- Pensacola, FL
National Provider Identifier
1386187565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ISW10899
- Practice address
- 112 W Cervantes St
Pensacola, FL 32501-3128 - Phone
- (850) 466-3200
- Fax
- (850) 466-3203
- NPI assigned
- Nov 21, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | ISW10899 | FL | Primary |
Addresses
Primary practice location
112 W Cervantes St
Pensacola, FL 32501-3128
Mailing address
112 W Cervantes St
Pensacola, FL 32501-3128
Phone (850) 466-3200
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
| License | State | Type | Specialty |
|---|---|---|---|
| ISW10899 | FL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479686400000",
"number": "1386187565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 W CERVANTES ST",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325013128",
"telephone_number": "850-466-3200",
"fax_number": "850-466-3203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 W CERVANTES ST",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325013128",
"telephone_number": "850-466-3200",
"fax_number": "850-466-3203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYWALD",
"first_name": "DOMINIQUE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-21",
"last_updated": "2016-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "FL",
"license": "ISW10899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.