Stanford James Maddox

Primary specialty

ContractorTaxonomy code 171W00000X

Practice address

2250 Oak Rd Unit 815
Snellville, GA 30078-1905

Phone

(770) 899-6364

NPI assigned

Jun 29, 2018

Last updated

Sep 9, 2020By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Meltdown Fitness Atlanta, LLC

  dba Rehab and Beyond

  • Physical Therapist
  • Tucker, GA
  • NPI 1346855160

  Multi-Specialty

  NPD Authorized official
• Rehab and Beyond, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Stone Mountain, GA
  • NPI 1356827869
  NPD Authorized official

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1528553716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 OAK RD UNIT 815",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300781905",
            "telephone_number": "770-899-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 OAK RD UNIT 815",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300781905",
            "telephone_number": "770-899-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "STANFORD",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-29",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS INFO",
            "identifier": "455255557",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alisha Macauley, M.S., NCC, LPC
• Marissa Allen Macdonald
• Laura Maclaren, ATC
• Karen Macnamee
• Nicholas Maddox
• Mademind Wellness & Performance
• Wilfrido Matinezo Magat, M.D.
• Magz Health Services, Inc.
• Mahon Family Medicine
• Thomas M Mahon, MD

• Contractor in Snellville, GA
• Providers in Snellville, GA by specialty
• Contractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.