John L. Maddox, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G40606 Issued in CA

Practice address

1300 S Eliseo Dr Ste 207
Greenbrae, CA 94904-2015

Phone

(415) 925-0550

Fax

(415) 925-9062

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: john.maddox.1@14789.direct.athenahealth.com

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1790837508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S ELISEO DR STE 207",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042015",
            "telephone_number": "415-925-0550",
            "fax_number": "415-925-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S ELISEO DR STE 207",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042015",
            "telephone_number": "415-925-0550",
            "fax_number": "415-925-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "JOHN",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G40606",
            "primary": true
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "CA",
            "license": "G40606",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "G40606",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G406060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalya Lvoff, M.D.
• Nancy Ma
• John Maa, MD
• Gordon S Macdonald, DDS
• Ruth D Macquarrie, M.D.
• Rina Madrinan, RN
• Nazanin Mahdieh
• Katherine Taraban Mahoney, PT, DPT
• Kate Malasig, PHARMD
• Nilma Arshad Malik, MD

• Dermatology Physician in Greenbrae, CA
• Providers in Greenbrae, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.