Active NPI
Paige Renee Maynard, B.S, IECE, TVI
- Developmental Therapist
- Louisville, KY
National Provider Identifier
1700168945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 1906 Goldsmith LN
Louisville, KY 40218-2066 - Phone
- (502) 636-0024
- Fax
- (502) 498-2954
- NPI assigned
- Sep 14, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | PENDING | KY | |
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
1906 Goldsmith LN
Louisville, KY 40218-2066
Mailing address
1906 Goldsmith LN
Louisville, KY 40218-2066
Phone (502) 636-0024
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)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PENDING | KY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visually Impaired Preschoolers Services of Greater Louisville, Inc. | 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.
-
- Community/Behavioral Health Agency
- Louisville, KY
- NPI 1346466372
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464134400000",
"number": "1700168945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1906 GOLDSMITH LN",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402182066",
"telephone_number": "502-636-0024",
"fax_number": "502-498-2954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1906 GOLDSMITH LN",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402182066",
"telephone_number": "502-636-0024",
"fax_number": "502-498-2954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYNARD",
"first_name": "PAIGE",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "B.S, IECE, TVI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-14",
"last_updated": "2016-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "KY",
"license": "PENDING",
"primary": false
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.