Individual provider Active NPI

Maxwell Davis Fleming

  • Student in an Organized Health Care Education/Training Program
  • Lafayette, IN
National Provider Identifier
1699686469
Registry record updated Sep 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
45025108A Issued in IN
Practice address
3630 S 18TH St
Lafayette, IN 47909-9102
Phone
(765) 474-3834
NPI assigned
Sep 12, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 45025108A IN Primary

Addresses

Primary practice location

3630 S 18TH St
Lafayette, IN 47909-9102

Mailing address

3204 S 9TH St Apt G
Lafayette, IN 47909-2992
Phone (616) 218-3838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789171200000",
    "number": "1699686469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 S 9TH ST APT G",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479092992",
            "telephone_number": "616-218-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 S 18TH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479099102",
            "telephone_number": "765-474-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING",
        "first_name": "MAXWELL",
        "middle_name": "DAVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-12",
        "last_updated": "2026-09-12",
        "certification_date": "2026-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "45025108A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.