NPIMap

Individual provider Active NPI

Ladonna K Maxwell, APRN

  • Family Nurse Practitioner
  • Great Falls, MT
National Provider Identifier
1417037292
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN23096 Issued in MT
Practice address
2300 12TH Ave S Ste 101
Great Falls, MT 59405-5017
Phone
(406) 761-5252
Fax
(406) 761-3626
NPI assigned
Oct 16, 2006
Last updated
Feb 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN23096 MT
Family Nurse Practitioner 363LF0000X RN23096 MT Primary

Addresses

Primary practice location

2300 12TH Ave S Ste 101
Great Falls, MT 59405-5017

Mailing address

PO Box 7167
Great Falls, MT 59406-7167
Phone (406) 761-5252

Other practice location 1

601 1st Ave N
Great Falls, MT 59401-2510
Phone (406) 761-5252

Other identifiers 3

IdentifierTypeStateIssuer
000375060OtherMTBLUE CROSS
4306338MedicaidMT
203274480OtherMTTRICARE & COMMERCIAL

Other names 1

  • Ladonna K Ladd Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040107000863 MT Practitioner - Nurse Practitioner 6608775788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2300 12TH Ave S
Suite 101
Great Falls, MT 59405-5017
Phone (406) 761-5252

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN23096MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri River Healthcare PLLC Family CurrentSince Sep 1, 2005 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

2300 12th Ave S
Ste 101
Great Falls, MT 59405
Phone (406) 727-1131

601 1st Ave N
Great Falls, MT 59401
Phone (406) 454-5074

926 13th Ave S
Great Falls, MT 59405
Phone (406) 761-5252

Organizations & group practices 2

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

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1417037292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7167",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594067167",
            "telephone_number": "406-761-5252",
            "fax_number": "406-761-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 12TH AVE S STE 101",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055017",
            "telephone_number": "406-761-5252",
            "fax_number": "406-761-3626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 1st Ave N",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594012510",
            "country_code": "US",
            "telephone_number": "406-761-5252",
            "fax_number": "406-761-3626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "LADONNA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "RN23096",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "RN23096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000375060",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4306338",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE & COMMERCIAL",
            "identifier": "203274480",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LADONNA",
            "last_name": "LADD",
            "middle_name": "K",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.