Max M Midkiff

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

APRN.CNP.026578 Issued in OH

Practice address

2510 Commons Blvd Ste 210
Beavercreek, OH 45431-3821

Phone

(937) 429-0607

Fax

(937) 429-0608

NPI assigned

Jul 27, 2020

Sex

Male

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1568071538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 COMMONS BLVD STE 210",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313821",
            "telephone_number": "937-558-3062",
            "fax_number": "937-558-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 COMMONS BLVD STE 210",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313821",
            "telephone_number": "937-429-0607",
            "fax_number": "937-429-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDKIFF",
        "first_name": "MAX",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.026578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Beavercreek, OH by specialty
• Acute Care Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.