Maxine McGowan, MSN, PHD, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

RN201165 Issued in GA

Practice address

3866 Augustine PL
Rex, GA 30273-5822

Phone

(678) 343-1257

Fax

(770) 507-2352

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

Yes

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 NJ, GA, WI, MN, TX, MO, PA, IA, NE, KS, FL, CT12 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 12

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Topaz Bay Senior Health PC 30 clinicians

Tapestry Telehealth PLLC 80 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Doctor of Philosophy

State licenses

Practice roles

Locations (25 of 30)

Interoperability endpoints

• Direct secure messaging: maxine.mcgowan.1@14059.direct.athenahealth.com

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.

• Tapestry Telehealth PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chillicothe, OH
  • NPI 1992215446

  CT, FL, GA, IA, KS, MN, MO, NE, NJ, PA, TX, WI

  Medicare reassignment Care Compare group
• Topaz Bay Senior Health PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Hoboken, NJ
  • NPI 1194518134

  FL, GA, KS, MO, NJ

  Medicare reassignment Care Compare group
• Post Acute Care Leaders LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Carrollton, GA
  • NPI 1033689336

  GA, Nurse Practitioner

  Medicare reassignment NPD
• Emerald Fern Wellness PC

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1134012545

  KS, MO, TX

  Medicare reassignment
• Rosewood Hills Healthcare PC

  • Internal Medicine Physician
  • Birmingham, AL
  • NPI 1922891969

  GA

  Medicare reassignment
• Nurse Practitioners in Long Term Care Limited Liability Company

  • Nurse Practitioner
  • Union, NJ
  • NPI 1780858191
  NPD (past) Authorized official
• Chess Medicine PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Montebello, NY
  • NPI 1699385021
  NPD

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1407907371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6571 YARBROUGH DR",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302134649",
            "telephone_number": "678-343-1257",
            "fax_number": "770-306-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3866 AUGUSTINE PL",
            "city": "REX",
            "state": "GA",
            "postal_code": "302735822",
            "telephone_number": "678-343-1257",
            "fax_number": "770-507-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "MAXINE",
        "credential": "MSN, PHD, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NR07760600",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN201165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8482306",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clarissa Lewis, LPC, CPCS
• LJB Non Medical Transportation
• Reginald Louis
• Denise Elecia Lyn-Bradley, LPC
• Janarra Kathryn Mallory-Crawford, MSN, RN, AGPCNP-BC
• Medical Group Consultant LLC
• Karen N Miller
• Alisha Mitto
• Nakilaha Murray
• Beatrice Nduwimana

• All providers in Rex, GA
• Primary Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.