Active NPI
Craig R Maki, PAC
- Physician Assistant
- Marshall, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 8902
- Practice address
- 1420 E College Dr
Marshall, MN 56258 - Phone
- (507) 532-9631
- Fax
- (507) 532-1176
- NPI assigned
- Feb 27, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 8902 | MN | Primary |
Addresses
Primary practice location
1420 E College Dr
Marshall, MN 56258
Mailing address
1420 E College Dr
Marshall, MN 56258
Phone (507) 532-9631
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8902 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera Marshall | Current | Accepting new patients | |
| Avera Marshall | Current | Accepting new patients | |
| Carris Health LLC | Current | Accepting new patients |
Locations
1521 Carlson St
Marshall, MN 56258
Phone (507) 532-1101
300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631
101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Avera Marshall Regional Medical Center
- Critical Access Hospital
- Marshall, MN
- NPI 1568401016
-
dba Avera Medical Group Carlson
- Multi-Specialty Clinic/Center
- Marshall, MN
- NPI 1407330301
-
- Multi-Specialty Clinic/Center
- Willmar, MN
- NPI 1598236408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1649246950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 E COLLEGE DR",
"city": "MARSHALL",
"state": "MN",
"postal_code": "56258",
"telephone_number": "507-532-9631",
"fax_number": "507-532-1176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 E COLLEGE DR",
"city": "MARSHALL",
"state": "MN",
"postal_code": "56258",
"telephone_number": "507-532-9631",
"fax_number": "507-532-1176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAKI",
"first_name": "CRAIG",
"middle_name": "R",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-27",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "8902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshall, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.