Active NPI
Maxwell Rubin
- Contractor
- Lawrenceville, GA
National Provider Identifier
1396562898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 5145 Sugarloaf Plwy
Lawrenceville, GA 30043 - Phone
- (470) 257-7005
- NPI assigned
- Sep 25, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | |||
| Contractor | 171W00000X | GA | Primary |
Addresses
Primary practice location
5145 Sugarloaf Plwy
Lawrenceville, GA 30043
Mailing address
5415 Sugarloaf Pkwy Ste 2203
Lawrenceville, GA 30043-7832
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1396562898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5415 SUGARLOAF PKWY STE 2203",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300437832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5145 SUGARLOAF PLWY",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "30043",
"telephone_number": "470-257-7005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBIN",
"first_name": "MAXWELL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-25",
"last_updated": "2024-09-25",
"certification_date": "2024-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": false
},
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.