Active NPI
Evelyn Jane Maddux, MS, PH.D.
- Psychologist
- Starke, FL
National Provider Identifier
1538497011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY 6804
- Practice address
- 2569 State Road 230 E
Starke, FL 32091-7005 - Phone
- (352) 327-1563
- NPI assigned
- Nov 22, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY 6804 | FL | Primary |
Addresses
Primary practice location
2569 State Road 230 E
Starke, FL 32091-7005
Mailing address
2569 State Road 230 E
Starke, FL 32091-7005
Phone (352) 327-1563
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 6804 | FL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258934400000",
"number": "1538497011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2569 STATE ROAD 230 E",
"city": "STARKE",
"state": "FL",
"postal_code": "320917005",
"telephone_number": "352-327-1563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2569 STATE ROAD 230 E",
"city": "STARKE",
"state": "FL",
"postal_code": "320917005",
"telephone_number": "352-327-1563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDUX",
"first_name": "EVELYN",
"middle_name": "JANE",
"name_prefix": "Dr.",
"credential": "MS, PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-22",
"last_updated": "2009-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY 6804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Starke, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.