NPIMap

Organization Active NPI

Maxim Healthcare Services, Inc.

  • Home Health Agency
  • Gainesville, GA
National Provider Identifier
1477748770
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
069-R-0417 Issued in GA
Legal business name
MAXIM HEALTHCARE SERVICES, INC.
Practice address
715 Queen City Pkwy
Suite 103
Gainesville, GA 30501-4348
Phone
(770) 535-1882
Fax
(770) 535-1883
NPI assigned
Sep 10, 2007
Last updated
Jul 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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

Authorized official

Name
Mr. Duane D Brickhouse
Title
Regional VP of Finance
Phone
(410) 910-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 069-R-0417 GA Primary

Addresses

Primary practice location

715 Queen City Pkwy
Suite 103
Gainesville, GA 30501-4348

Mailing address

7227 Lee Deforest Dr
Columbia, MD 21046-3236
Phone (410) 910-1500

Other identifiers 2

IdentifierTypeStateIssuer
000699542WMedicaidGA
000699542AJMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Maxim Healthcare Services Inc337 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 8

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

715 Queen City Pkwy
Ste 103
Gainesville, GA 30501
Phone (770) 535-1882

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1477748770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 LEE DEFOREST DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463236",
            "telephone_number": "410-910-1500",
            "fax_number": "410-910-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 QUEEN CITY PKWY",
            "address_2": "SUITE 103",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305014348",
            "telephone_number": "770-535-1882",
            "fax_number": "770-535-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "BRICKHOUSE",
        "authorized_official_first_name": "DUANE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "REGIONAL VP OF FINANCE",
        "authorized_official_telephone_number": "410-910-1500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "069-R-0417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000699542W",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000699542AJ",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; 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.