Jeremiah J Maxwell, CST

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Practice address

2513 W 2400 S
Heber City, UT 84032-3624

Phone

(435) 671-0838

NPI assigned

Oct 27, 2014

Last updated

Oct 27, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1780089268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 W 2400 S",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840323624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2513 W 2400 S",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840323624",
            "telephone_number": "435-671-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "JEREMIAH",
        "middle_name": "J",
        "credential": "CST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marci Heugly CMHC LLC
• Ashley Karen Mathis, MS, RDN, CD
• Nathaniel Q Matis
• Rolayne G Mattsson, RPT
• Janine Maurice, R.T.(R)(CT)
• Tyler D May, DDS
• Erik McClure, DO
• Jonathan McCormick, PT, DPT
• Richard H McDonald, CMHC
• Stanton McDonald, M.D.

• Surgical Assistant in Heber City, UT
• Providers in Heber City, UT by specialty
• Surgical Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.