Jimmy H Maddox, RN/MSN/FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN166580 Issued in GA

Practice address

117 Kite Road
Swainsboro, GA 30401

Phone

(478) 289-1265

NPI assigned

Oct 2, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Optum Care Services Company

  • Family Nurse Practitioner
  • Columbia, MD
  • NPI 1912199415

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1487989885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 KITE ROAD",
            "address_2": "P.O. BOX 879",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "30401",
            "telephone_number": "478-289-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 KITE ROAD",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "30401",
            "telephone_number": "478-289-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "JIMMY",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "RN/MSN/FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-02",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN166580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harvey Robert Langee Jr., MD
• Sarah Sutton Lewis
• Pamela R Love, N.P
• Nicholas Luecke, NP
• Claudio D Machado, MD
• Mark D Smith DMD PC
• Pamela Mashburn, RPH
• Maximum Medical Inc
• Maximum Medical SE, Inc.
• Julianne Fricks McCaskill, PA-C

• Family Nurse Practitioner in Swainsboro, GA
• Providers in Swainsboro, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.