Gary Raymond Maddox, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

12214 Issued in CA

Practice address

4625 1St St Ste 100
Pleasanton, CA 94566-7368

Phone

(925) 202-9561

Fax

(925) 462-9477

NPI assigned

Mar 5, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538298369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 1ST ST STE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667368",
            "telephone_number": "925-202-9561",
            "fax_number": "925-462-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 1ST ST STE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667368",
            "telephone_number": "925-202-9561",
            "fax_number": "925-462-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "GARY",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "12214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Pleasanton, CA
• Providers in Pleasanton, CA by specialty
• Chiropractor in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.