NPIMap

Individual provider Active NPI

A Michele Maxwell, CNP

  • Family Nurse Practitioner
  • Crossett, AR
National Provider Identifier
1669937488
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A006090 Issued in AR
Practice address
201 Fairview Rd Ste a
Crossett, AR 71635-4537
Phone
(870) 364-0000
Fax
(870) 364-0199
NPI assigned
Feb 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A006090 AR Primary

Addresses

Primary practice location

201 Fairview Rd Ste a
Crossett, AR 71635-4537

Mailing address

PO Box 2650
Pine Bluff, AR 71613-2650
Phone (870) 541-7211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190724001255 AR Practitioner - Nurse Practitioner 4082940358 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson Hospital Association, Inc 80 clinicians

Practice addresses (Care Compare)

201 Fairview Rd
Suite a
Crossett, AR 71635-4537
Phone (870) 364-0000

Hospital & facility affiliations

  • Acmc Family Home Health Home health agency, Crossett, AR, CCN 047109
  • Ashley County Medical Center Hospital, Crossett, AR, CCN 041323
  • Jefferson Regional Medical Center Hospital, Pine Bluff, AR, CCN 040071
  • Baptist Health Medical Center-Drew County Hospital, Monticello, AR, CCN 040051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Hospital Association, Inc CurrentSince Sep 1, 2023 Accepting new patients
Jefferson Hospital Association, Inc Current Accepting new patients
Jefferson Hospital Association, Inc CurrentSince Sep 1, 2023 Accepting new patients
Connelley Family Medical, PLLC CurrentSince Nov 1, 2022 Accepting new patients
Timothy R Cook MD Past Accepting new patients

Locations

201 Fairview Rd
Ste A
Crossett, AR 71635
Phone (870) 364-0000

906 Roberts Dr
Monticello, AR 71655
Phone (870) 367-6867

906 Roberts Dr
Ste B
Monticello, AR 71655
Phone (870) 367-1461

1222 Old Warren Rd
Ste A
Monticello, AR 71655
Phone (870) 460-9001

1600 W 40th Ave
Pine Bluff, AR 71603
Phone (870) 541-7100

1601 W 40th Ave
Ste 301
Pine Bluff, AR 71603
Phone (870) 541-4285

1609 W 40th Ave
Ste 403
Pine Bluff, AR 71603
Phone (870) 534-4188

Interoperability endpoints

  • Direct secure messaging: mimaxwell@landmarkhealth-direct.org
  • Direct secure messaging: michele.maxwell.1@2554.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CHCGBD

Organizations & group practices 11

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1669937488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2650",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716132650",
            "telephone_number": "870-541-7211",
            "fax_number": "870-541-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 FAIRVIEW RD STE A",
            "city": "CROSSETT",
            "state": "AR",
            "postal_code": "716354537",
            "telephone_number": "870-364-0000",
            "fax_number": "870-364-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "A",
        "middle_name": "MICHELE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A006090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossett, AR

Sources for this page

Verify at the official NPI Registry.