Brett Jared Maynor, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40480 Issued in CA

Practice address

25790 Lawton Ave
Loma Linda, CA 92354-3824

Phone

(360) 904-8120

NPI assigned

Sep 4, 2013

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services - WashingtonGroup PAC ID 2860552973, 266 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bmaynor535969@wm.providencedirect.org

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.

• Providence Health & Services - Washington

  • Family Medicine Physician
  • Walla Walla, WA
  • NPI 1922259738

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Washington

  • Neurological Surgery Physician
  • Walla Walla, WA
  • NPI 1760636690
  NPD
• Providence Health & Services - Washington

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  NPD (past)

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1528493913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25790 LAWTON AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543824",
            "telephone_number": "360-904-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25790 LAWTON AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543824",
            "telephone_number": "360-904-8120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 Chase Ave",
            "address_purpose": "LOCATION",
            "city": "Walla Walla",
            "state": "WA",
            "postal_code": "993622924",
            "country_code": "US",
            "telephone_number": "509-897-3500",
            "fax_number": "509-897-5570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYNOR",
        "first_name": "BRETT",
        "middle_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-04",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "40480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bmaynor535969@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "380 Chase Ave",
            "city": "Walla Walla",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993622924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kenneth L Maxwell II, D.O.
• William N. May, M.D.
• Cesar Maya
• Kimberly Mayekawa, MD
• Theresa L Mayer, RN
• Jacob Mayor, MD
• Joseph Lee Mayor, MD
• Robynn Mays
• Mazna Ahmad MD Inc
• Sarah H Mazumder, PHARMD

• Physical Therapist in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.