Individual provider Active NPI

John Knox Maltby, DC

  • Chiropractor
  • Blythe, CA
National Provider Identifier
1417973322
Registry record updated Nov 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC11971 Issued in CA
Practice address
320 E Hobsonway
Blythe, CA 92225-1733
Phone
(760) 922-7353
Fax
(760) 922-9121
NPI assigned
Jul 14, 2006
Last updated
Nov 4, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC11971 CA Primary

Addresses

Primary practice location

320 E Hobsonway
Blythe, CA 92225-1733

Mailing address

320 E Hobsonway
Blythe, CA 92225-1733
Phone (760) 922-7353

Other identifiers 1

IdentifierTypeStateIssuer
350055075OtherCARAILROAD RETIREMENT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111213000401 CA Practitioner - Chiropractic 5092980433 Practice locations: Blythe, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1977
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

320 E Hobsonway
Blythe, CA 92225-1733
Phone (760) 922-7353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC11971CAMDChiropractor

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225756800000",
    "number": "1417973322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E HOBSONWAY",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922251733",
            "telephone_number": "760-922-7353",
            "fax_number": "760-922-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E HOBSONWAY",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922251733",
            "telephone_number": "760-922-7353",
            "fax_number": "760-922-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALTBY",
        "first_name": "JOHN",
        "middle_name": "KNOX",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC11971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIREMENT",
            "identifier": "350055075",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blythe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.