Robert P Maddox Jr., DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08000602A Issued in IN

Practice address

1100 N State Road 135
Suite BCD
Greenwood, IN 46142-1034

Phone

(317) 881-6013

Fax

(317) 881-1395

NPI assigned

Jan 18, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497807234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N STATE ROAD 135",
            "address_2": "SUITE BCD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421034",
            "telephone_number": "317-881-6013",
            "fax_number": "317-881-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N STATE ROAD 135",
            "address_2": "SUITE BCD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421034",
            "telephone_number": "317-881-6013",
            "fax_number": "317-881-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "ROBERT",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08000602A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER #",
            "identifier": "000000198008",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "08000602",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USAA #",
            "identifier": "6003957",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORK COMP #",
            "identifier": "606",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.