Active NPI
Mark Alan Maxwell
- Pharmacist
- Lincoln, NE
National Provider Identifier
1548861255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14456
- Practice address
- 8700 Andermatt Dr
Lincoln, NE 68526-9653 - Phone
- (402) 484-6342
- Fax
- (402) 484-6349
- NPI assigned
- Nov 8, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14456 | NE | Primary |
Addresses
Primary practice location
8700 Andermatt Dr
Lincoln, NE 68526-9653
Mailing address
9415 Del Rio Dr
Lincoln, NE 68516-5997
Phone (402) 646-5988
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14456 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604793600000",
"number": "1548861255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9415 DEL RIO DR",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685165997",
"telephone_number": "402-646-5988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 ANDERMATT DR",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685269653",
"telephone_number": "402-484-6342",
"fax_number": "402-484-6349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXWELL",
"first_name": "MARK",
"middle_name": "ALAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-08",
"last_updated": "2020-11-08",
"certification_date": "2020-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "14456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.