Active NPI
Maxwell Davis Fleming
- Student in an Organized Health Care Education/Training Program
- Lafayette, IN
National Provider Identifier
1699686469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 45025108A
- 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
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 |
|---|---|---|---|---|
| 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.