Individual provider Active NPI

James Lewis Maynard, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Rock Hill, SC
National Provider Identifier
1679565196
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
7316 Issued in SC
Practice address
222 S Herlong Ave
Rock Hill, SC 29732-1158
Phone
(803) 329-1234
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 7316 SC
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 7316 SC Primary

Addresses

Primary practice location

222 S Herlong Ave
Rock Hill, SC 29732-1158

Mailing address

PO Box 6426
Christiansburg, VA 24068-6426

Other identifiers 2

IdentifierTypeStateIssuer
073164MedicaidSC
27689OtherMEDCOST

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7316SCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
York Pathology Associates PA Specialist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1679565196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6426",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240686426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S HERLONG AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321158",
            "telephone_number": "803-329-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "JAMES",
        "middle_name": "LEWIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "7316",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "7316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073164",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "27689",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.