Kevin W Maddox, DO

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

5590 Issued in OK

Practice address

1921 Stonecipher Blvd
Ada, OK 74820

Phone

(580) 421-4570

Fax

(614) 442-2430

NPI assigned

May 3, 2010

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

Enrolled in TX, OK, CO, UT4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Pathology

Education

Lake Erie College of Osteopathic Medicine, Bradenton, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain States Pathology PCGroup PAC ID 4284616293, 16 clinicians

Chickasaw Nation Division of Health Chickasaw Nation Medical CenterGroup PAC ID 8426957523, 243 clinicians

Southern Oklahoma Pathology Assoc IncGroup PAC ID 9739162694, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013
• Holy Cross Hospital-Davis Hospital, Layton, UT, CCN 460041
• Holy Cross Hospital-Jordan Valley Hospital, West Jordan, UT, CCN 460051
• Centura Health-Penrose St Francis Health Services Hospital, Colorado Springs, CO, CCN 060031
• Holy Cross Hospital - Salt Lake Hospital, Salt Lake City, UT, CCN 460003

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chickasaw Nation Division of Health

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1255364923

  TX

  Medicare reassignment Care Compare group NPD
• Southern Oklahoma Pathology Assoc., Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Ada, OK
  • NPI 1508978149
  Medicare reassignment Care Compare group NPD
• Mountain States Pathology PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Colorado Springs, CO
  • NPI 1710941158

  UT

  Medicare reassignment Care Compare group NPD
• Chickasaw Nation Division of Health

  • Home Health Agency
  • Ada, OK
  • NPI 1811739071
  NPD
• Chickasaw Nation Division of Health

  • Primary Care Clinic/Center
  • Purcell, OK
  • NPI 1982764395
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1043915523
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1083611644
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Layton, UT
  • NPI 1346945839
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1588204010
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1679113104
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Aztec, NM
  • NPI 1770123382
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1801436415
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • West Jordan, UT
  • NPI 1801591391
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1932112125
  Care Compare affiliation

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1598082398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20452",
            "address_2": "SOPA/APA CRED",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432200452",
            "telephone_number": "614-442-2406",
            "fax_number": "614-442-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER BLVD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "74820",
            "telephone_number": "580-421-4570",
            "fax_number": "614-442-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "KEVIN",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-03",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OK",
            "license": "5590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Reid Lynner, DC
• Dawsyn Lyon
• Wajiha Maan, MD
• Marissa Danielle Madden
• Hannabella Maddox
• Spring Gennay Maddox, CNM, WHNP
• Felton Chile Madume
• Sydney Caitlin Manning
• Lonnie Roy Manuel, L.P.C.
• Olivia Manuel

• Anatomic Pathology & Clinical Pathology Physician in Ada, OK
• Providers in Ada, OK by specialty
• Anatomic Pathology & Clinical Pathology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.