Individual provider Active NPI

Judith Maxy

  • Registered Nurse
  • Jacksonville, FL
National Provider Identifier
1609309178
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN9419064 Issued in FL
Practice address
7406 Fullerton St Ste 200
Jacksonville, FL 32256-3597
Phone
(904) 538-0440
NPI assigned
Apr 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9419064 FL Primary

Addresses

Primary practice location

7406 Fullerton St Ste 200
Jacksonville, FL 32256-3597

Mailing address

18640 NW 2ND Ave
Miami, FL 33269-7115
Phone (786) 399-2902

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

LicenseStateTypeSpecialty
RN9419064FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ingenios Health Co. PastSince Oct 6, 2014 Accepting new patients
Pophealthcare, LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1609309178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18640 NW 2ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332697115",
            "telephone_number": "786-399-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7406 FULLERTON ST STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563597",
            "telephone_number": "904-538-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXY",
        "first_name": "JUDITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9419064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.