Active NPI
Reid Maddox, LMT
- Massage Therapist
- Fort Smith, AR
National Provider Identifier
1619001765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 2163
- Practice address
- 2301 S 56TH St
Siute 104
Fort Smith, AR 72903-3755 - Phone
- (479) 739-5555
- NPI assigned
- Mar 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 2163 | AR | Primary |
Addresses
Primary practice location
2301 S 56TH St
Siute 104
Fort Smith, AR 72903-3755
Mailing address
5105 Gary St
Fort Smith, AR 72903-4638
Phone (479) 739-5555
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 |
|---|---|---|---|
| 2163 | AR | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619001765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5105 GARY ST",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729034638",
"telephone_number": "479-739-5555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 S 56TH ST",
"address_2": "SIUTE 104",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729033755",
"telephone_number": "479-739-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDOX",
"first_name": "REID",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AR",
"license": "2163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
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.