Organization Active NPI

Maxim Healthcare Services, Inc.

  • Home Health Agency
  • Denver, CO
National Provider Identifier
1649234782
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MAXIM HEALTHCARE SERVICES, INC.
Practice address
455 N Sherman St Ste 510
Denver, CO 80203-4405
Phone
(303) 487-7143
Fax
(303) 487-7203
NPI assigned
Apr 14, 2006
Organization subpart
Yes
Parent organization
MAXIM HEALTHCARE SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Authorized official

Name
Mr. David S Kowalczyk
Title
Regional Controller
Phone
(410) 910-1730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

455 N Sherman St Ste 510
Denver, CO 80203-4405

Mailing address

7227 Lee Deforest Drive
Columbia, MD 21046-3405
Phone (410) 910-1500

Other identifiers 1

IdentifierTypeStateIssuer
52559831MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071002000222 CO Part A Provider - Home Health Agency 1658288410 Practice locations: Denver, CO

Home health agency certification: CCN 067486

Legal name
MAXIM HEALTHCARE SERVICES INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 5, 2010
Last certification
Jul 1, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Sep 1, 1988 in MD
Enrollment address
455 N Sherman St
Ste 510
Denver, CO 80203-4405
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Maxim Healthcare Services IncCCN 067486 · All quality measures
Ownership
Proprietary
Certified
Nov 5, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide

National Provider Directory

National Provider Directory
Part of
Maxim Healthcare Servise

Locations

3300 N Central Ave
Ste 2500
Phoenix, AZ 85012
Phone (602) 216-0110

5151 E Broadway Blvd
Ste 1200
Tucson, AZ 85711
Phone (520) 790-8200

4540 California Ave
Ste 400
Bakersfield, CA 93309
Phone (661) 322-3039

47250 Washington St
Ste B
La Quinta, CA 92253
Phone (760) 469-3169

4712 Stoddard Rd
Ste 280
Modesto, CA 95356
Phone (209) 222-5490

1651 Response Rd
Ste 200
Sacramento, CA 95815
Phone (916) 974-2599

27555 Ynez Rd
Ste 300
Temecula, CA 92591
Phone (951) 466-3196

3665 John F Kennedy Pkwy
Ste 330
Fort Collins, CO 80525

317 W 3rd St
Ste 100
La Junta, CO 81050
Phone (719) 383-0445

11 Executive Dr
Ste 1
Fairview Heights, IL 62208
Phone (618) 628-7551

10811 W 143rd St
Ste 210
Orland Park, IL 60467
Phone (708) 459-9121

973 Featherstone Rd
Ste 210
Rockford, IL 61107
Phone (815) 484-0000

1954 Greenspring Dr
#330335
Lutherville Timonium, MD 21093

1120 Benfield Blvd
Ste Ab
Millersville, MD 21108
Phone (443) 274-3071

8300 Jefferson St NE
Ste A
Albuquerque, NM 87113
Phone (505) 542-3131

10220 SW Greenburg Rd
Ste 500
Portland, OR 97223
Phone (503) 452-4545

9815 S Monroe St
Ste 400
Sandy, UT 84070
Phone (801) 685-7070

406 W Main St
Fl 2
Abingdon, VA 24210
Phone (276) 619-5106

100 Concourse Blvd
Ste 101
Glen Allen, VA 23059
Phone (804) 355-9800

1332 Plantation Rd NE
Roanoke, VA 24012
Phone (540) 725-1572

12632 Darby Brook Ct
#B3B4
Woodbridge, VA 22192

950 Broadway
Ste 301
Tacoma, WA 98402
Phone (253) 292-4354

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joseph W Marshall Individual Corporate DirectorBoard Member Jul 1, 2017
Randall D Sones Individual Corporate DirectorBoard Member Aug 25, 2009
Jarrod L Depriest Individual Corporate OfficerPresident/ Ceo Jan 1, 2022
Matthew Sticklin Individual Corporate OfficerCfo Aug 29, 2022
David S. Kowalczyk Individual W-2 Managing EmployeeRegional VP Finance Oct 15, 2012
Toni-Jean L Friedman Individual Corporate OfficerVP, General Counsel, Secretary Nov 1, 2009
Oak Investment Trust Organization, Tampa, FL 5% Or Greater Indirect Ownership Interest Mar 18, 2019 39.89%
Stephen J Bisciotti Individual 5% Or Greater Indirect Ownership Interest Mar 18, 2019 19.73%
Oak Investment Trust II Organization, Tampa, FL 5% Or Greater Indirect Ownership Interest Mar 18, 2019 39.35%
Maxim Healthcare Services Holdings, Inc. Organization, Columbia, MD Corporation, Holding company, For-profit 5% Or Greater Direct Ownership Interest Mar 18, 2019 100%

All facility ownership & control disclosures 27

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Maxim Healthcare Services IncPueblo, CO, CCN 067413 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncPoland, OH, CCN 368042 Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services IncPittsburgh, PA, CCN 397783 Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services IncTucson, AZ, CCN 037228 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncSandy, UT, CCN 467212 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncBedford, NH, CCN 307085 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncHarrisburg, PA, CCN 397789 Home health agency Other Jan 9, 2006
Maxim Healthcare Services, Inc.Miamisburg, OH, CCN 368006 Home health agency Other Jan 9, 1996
Maxim Healthcare Services IncPlains, PA, CCN 398016 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncPhoenix, AZ, CCN 037242 Home health agency Other (100%) Apr 25, 2006
Maxim Healthcare Services IncMadison, WI, CCN 527290 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncCanton, OH, CCN 368007 Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services IncToledo, OH, CCN 367799 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncReno, NV, CCN 297049 Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services IncOxnard, CA, CCN 058352 Home health agency Other Jan 30, 2006
Maxim Healthcare Services IncAnchorage, AK, CCN 027032 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncFresno, CA, CCN 058323 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncLas Vegas, NV, CCN 297085 Home health agency Other (100%) Sep 2, 1988
Maxim Healthcare Services IncAllentown, PA, CCN 398065 Home health agency Other (100%) Jun 1, 2007
Maxim Healthcare Services IncColorado Springs, CO, CCN 067325 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncLa Junta, CO, CCN 067466 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncSan Luis Obispo, CA, CCN 059129 Home health agency Other (100%) Dec 4, 2009
Maxim Healthcare Services IncRoseville, CA, CCN 059117 Home health agency Operational/Managerial Control (100%) Jan 1, 2009
Maxim Healthcare Services IncYork, PA, CCN 398132 Home health agency Other (100%) Apr 28, 2010
Maxim Healthcare Services IncEvansville, IN, CCN 157680 Home health agency Other (100%) Jun 30, 2011
Maxim Healthcare Services IncCrown Point, IN, CCN 157679 Home health agency Other (100%) Jun 30, 2011
Maxim Healthcare Services IncLos Angeles, CA, CCN 053198 Home health agency Other (100%) Jun 30, 2011

Facilities with the same owner 69

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 69

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1649234782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 LEE DEFOREST DRIVE",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463405",
            "telephone_number": "410-910-1500",
            "fax_number": "410-910-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 N SHERMAN ST STE 510",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802034405",
            "telephone_number": "303-487-7143",
            "fax_number": "303-487-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "enumeration_date": "2006-04-14",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "REGIONAL CONTROLLER",
        "authorized_official_telephone_number": "410-910-1730",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52559831",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.