Maxim Healthcare Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

IT3059 Issued in NM

Legal business name

MAXIM HEALTHCARE SERVICES, INC.

Practice address

2155 Louisiana Blvd NE
Suite 5100
Albuquerque, NM 87110-5409

Phone

(505) 883-4444

Fax

(505) 883-9788

NPI assigned

May 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David S Kowalczyk

Title

Regional Controller

Phone

(410) 910-1500

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255910400000",
    "number": "1760435689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 LEE DEFOREST DRIVE",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463405",
            "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": "2155 LOUISIANA BLVD NE",
            "address_2": "SUITE 5100",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105409",
            "telephone_number": "505-883-4444",
            "fax_number": "505-883-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2009-10-19",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "REGIONAL CONTROLLER",
        "authorized_official_telephone_number": "410-910-1500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NM",
            "license": "IT3059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53154771",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A0637",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Maxedon, MS, LCGC
• Jo A Maxey
• Maxgoal LLC
• Maxim Healthcare Services, Inc.
• Maxim Healthcare Services, Inc.
• Maximum Impact Physical Therapy, LLC
• Maximum Impact Physical Therapy, LLC
• Emily Maxon, NP
• Briahna Frances Maxwell, LPCC
• Chris Maxwell, LPCC

• Home Health Agency in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Home Health Agency in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2009; 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.