Audrey Jane I Maddox, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

067679 Issued in GA

Practice address

173 W Dykes St Ste 102
Cochran, GA 31014-6921

Phone

(478) 934-0329

NPI assigned

Jul 2, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: audreyjanemaddox@trh.allscriptsdirect.net

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

• Primary Pediatrics, PC

  • Specialist
  • Macon, GA
  • NPI 1477638575
  NPD (past)
• Taylor Regional Hospital

  • Pediatrics Physician
  • Hawkinsville, GA
  • NPI 1720339336

  Pediatrics

  NPD (past)
• The Medical Center of Central Georgia Inc

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1043270564
  NPD (past)

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1396974093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 PERRY HWY",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310366748",
            "telephone_number": "478-783-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 W DYKES ST STE 102",
            "city": "COCHRAN",
            "state": "GA",
            "postal_code": "310146921",
            "telephone_number": "478-934-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "AUDREY JANE",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL31769",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "067679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA COMPOSITE MEDICAL BOARD",
            "identifier": "067679",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lewis Glenn Jones, RPH
• Ashley Lewis
• Lifeline EMS LLC
• Little Affiliate Horizons LLC
• Jacob Lunsford, PA-C
• Patrick Nelson Major, PHARMD
• Tanya S. Manning, M.ED. CCC/SLP
• Debbie Martin, RNC
• McDaniel Pharmacy
• Trenton McDaniel, PHARM D

• All providers in Cochran, GA
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.