NPIMap

Organization Active NPI

Maxim Healthcare Services, Inc.

  • Home Health Agency
  • Port St Lucie, FL
National Provider Identifier
1720245129
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299993344 Issued in FL
Legal business name
MAXIM HEALTHCARE SERVICES, INC.
Practice address
445 NW Prima Vista Blvd
Unit 107
Port St Lucie, FL 34983-8731
Phone
(561) 734-2371
Fax
(561) 733-8599
NPI assigned
May 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Authorized official

Name
Mrs. Kathy Jackson
Title
Regional Controller
Phone
(410) 910-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299993344 FL Primary

Addresses

Primary practice location

445 NW Prima Vista Blvd
Unit 107
Port St Lucie, FL 34983-8731

Mailing address

7227 Lee Deforest Dr
Columbia, MD 21046-3236
Phone (410) 910-1500

Other identifiers 1

IdentifierTypeStateIssuer
000534100MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Maxim Healthcare Servise337 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

Locations

445 NW Prima Vista Blvd
Unit 107
Port St Lucie, FL 34983
Phone (561) 734-2371

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262563200000",
    "number": "1720245129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 LEE DEFOREST DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463236",
            "telephone_number": "410-910-1500",
            "fax_number": "410-910-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 NW PRIMA VISTA BLVD",
            "address_2": "UNIT 107",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349838731",
            "telephone_number": "561-734-2371",
            "fax_number": "561-733-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2010-01-04",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "REGIONAL CONTROLLER",
        "authorized_official_telephone_number": "410-910-1500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299993344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000534100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.