Active NPI
Dorothy Windes Maxwell, NP
- Acute Care Nurse Practitioner
- Canyon Lake, CA
National Provider Identifier
1720946403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 95110281
- Practice address
- 30136 Skippers Way Dr
Canyon Lake, CA 92587-7404 - Phone
- (206) 861-9515
- NPI assigned
- Jan 12, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 95110281 | CA | Primary |
Addresses
Primary practice location
30136 Skippers Way Dr
Canyon Lake, CA 92587-7404
Mailing address
30136 Skippers Way Dr
Canyon Lake, CA 92587-7404
Phone (206) 861-9515
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95110281 | CA | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1768176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768176000000",
"number": "1720946403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30136 SKIPPERS WAY DR",
"city": "CANYON LAKE",
"state": "CA",
"postal_code": "925877404",
"telephone_number": "206-861-9515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30136 SKIPPERS WAY DR",
"city": "CANYON LAKE",
"state": "CA",
"postal_code": "925877404",
"telephone_number": "206-861-9515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXWELL",
"first_name": "DOROTHY",
"middle_name": "WINDES",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-01-12",
"last_updated": "2026-01-12",
"certification_date": "2026-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "CA",
"license": "95110281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canyon Lake, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.