Haley Maxon, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CP003372 Issued in SD

Practice address

922 22ND Ave S
Brookings, SD 57006-2830

Phone

(605) 679-1900

NPI assigned

Sep 13, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Sanford Medical Center

  dba Edith Sanford Breast Specialty Clinic

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1093090342
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732320000000",
    "number": "1669208799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 22ND AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062830",
            "telephone_number": "605-679-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXON",
        "first_name": "HALEY",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-11-23",
        "certification_date": "2024-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP003372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Lunn
• Rachel Lynde, NP-C
• Danise Maas, MS, LAT, ATC
• Kenric D Malmberg, MD
• Laura Martin
• Charles E. McCullough, CPT
• Maryanna May McCullough, OTA
• Sarah McGill
• Victoria McGinnis
• Rose McGuire, LMT

• Family Nurse Practitioner in Brookings, SD
• Providers in Brookings, SD by specialty
• Family Nurse Practitioner in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.