Donovan Maycock, NUTRITIONIST

Primary specialty

NutritionistTaxonomy code 133N00000X

Practice address

16610 San Pedro Avenue
San Antonio, TX 78232

Phone

(210) 778-4781

Fax

(210) 545-0444

NPI assigned

Oct 12, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1609151489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16610 SAN PEDRO AVENUE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78232",
            "telephone_number": "210-778-4781",
            "fax_number": "210-545-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16610 SAN PEDRO AVENUE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78232",
            "telephone_number": "210-778-4781",
            "fax_number": "210-545-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYCOCK",
        "first_name": "DONOVAN",
        "credential": "NUTRITIONIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-12",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12138706",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN FITNESS PROFESSIONALS ASSOCIATION- CERTIFIED NUTRITION AND WELLNESS",
            "identifier": "67752",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Savannah Lexine May
• Stephen Allen May, M.D.
• Taylor May, M.S., CCC-SLP
• James Rudy Mayberry
• Sarah-Madison Mayberry
• Claudia Fabiola Maydana
• Monica Marie Maydon
• Starr Shauna Mayen, D.D.S.
• Gerald Thomas Mayer, M.D.
• Michael I Mayer, PHARM.D.

• Nutritionist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Nutritionist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; 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.