Active NPI
Maxim Powiada, DC
- Sports Physician Chiropractor
- Scottsdale, AZ
National Provider Identifier
1568058287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 8990
- Practice address
- 19120 N Pima Rd Ste 100
Scottsdale, AZ 85255-5391 - Phone
- (503) 701-8147
- NPI assigned
- Dec 16, 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 |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 8990 | AZ | Primary |
Addresses
Primary practice location
19120 N Pima Rd Ste 100
Scottsdale, AZ 85255-5391
Mailing address
19120 N Pima Rd Ste 100
Scottsdale, AZ 85255-5391
Phone (503) 701-8147
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 |
|---|---|---|---|
| 8990 | AZ | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623628800000",
"number": "1568058287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19120 N PIMA RD STE 100",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852555391",
"telephone_number": "503-701-8147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19120 N PIMA RD STE 100",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852555391",
"telephone_number": "503-701-8147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWIADA",
"first_name": "MAXIM",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-16",
"last_updated": "2021-06-14",
"certification_date": "2021-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "AZ",
"license": "8990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.