Active NPI
Jeffrey Eades Maupin, P. T.
- Physical Therapist
- North East, MD
National Provider Identifier
1568501070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 22136
- Practice address
- 18 Montgomery Dr
Ste 10
North East, MD 21901-3817 - Phone
- (410) 287-5057
- NPI assigned
- Feb 5, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 22136 | MD | Primary |
Addresses
Primary practice location
18 Montgomery Dr
Ste 10
North East, MD 21901-3817
Mailing address
86 NE Isles Dr
North East, MD 21901-3107
Phone (443) 674-8155
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 |
|---|---|---|---|
| 22136 | MD | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568501070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86 NE ISLES DR",
"city": "NORTH EAST",
"state": "MD",
"postal_code": "219013107",
"telephone_number": "443-674-8155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 MONTGOMERY DR",
"address_2": "STE 10",
"city": "NORTH EAST",
"state": "MD",
"postal_code": "219013817",
"telephone_number": "410-287-5057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAUPIN",
"first_name": "JEFFREY",
"middle_name": "EADES",
"credential": "P. T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "22136",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North East, MD
Sources for this page
- 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.