Individual provider Active NPI

Maria Suzanne Madrid, CHW

  • Community Health Worker
  • Waxahachie, TX
National Provider Identifier
1396562955
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
10212 Issued in TX
Practice address
123 Cactus Rd
Waxahachie, TX 75165-6927
Phone
(972) 825-3713
NPI assigned
Sep 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 10212 TX Primary

Addresses

Primary practice location

123 Cactus Rd
Waxahachie, TX 75165-6927

Mailing address

123 Cactus Rd
Waxahachie, TX 75165-6927
Phone (972) 825-3713

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
10212TXMDCommunity Health Worker

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": "1396562955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 CACTUS RD",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751656927",
            "telephone_number": "972-825-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 CACTUS RD",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751656927",
            "telephone_number": "972-825-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADRID",
        "first_name": "MARIA",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "CHW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "TX",
            "license": "10212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxahachie, TX

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.

Verify at the official NPI Registry.