Mary Charniece Maddox, LPN,RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

520981 Issued in OH

Practice address

665 E 159TH St
Cleveland, OH 44110-2413

Phone

(216) 703-3320

NPI assigned

Sep 19, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1497239156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1073 THORNHILL DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441082316",
            "telephone_number": "216-703-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 E 159TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441102413",
            "telephone_number": "216-703-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "MARY",
        "middle_name": "CHARNIECE",
        "credential": "LPN,RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "OH",
            "license": "168309",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "520981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168398",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Delaat Madden
• Colin Maddock
• Emma K Maddocks
• Sharon Maddox Herron
• Jennifer Denice Maddox, C.N.A
• Nicole Monique Maddox, APRN
• Valerie Maddox
• William Maddox Jr., LSW, LICDC
• Annmarie Madera, MS, RDN, LD
• Jacqueline Madere, CRNA

• Registered Nurse in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.