Kenneth Scruggs Maxwell, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

9500660 Issued in NC

Practice address

110 Charlois Blvd
Winston Salem, NC 27103-1522

Phone

(336) 768-3361

Fax

(336) 768-4131

NPI assigned

Jan 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

74.6 of 100Reported as group

Quality

31.13

Promoting interoperability

99

Improvement activities

40

Cost

85.04

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kennethmaxwell@penta.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Piedmont Ear, Nose & Throat Associates, P.a.

  dba Piedmont Ear, Nose, and Throat

  • Otolaryngology Physician
  • Winston Salem, NC
  • NPI 1649216631
  Medicare reassignment NPD
• Charlotte Eye Ear Nose & Throat Associates, P.a.

  • Otolaryngology Physician
  • Winston Salem, NC
  • NPI 1710814405
  NPD (past)

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1801876768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031522",
            "telephone_number": "336-768-3361",
            "fax_number": "336-768-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031522",
            "telephone_number": "336-768-3361",
            "fax_number": "336-768-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "KENNETH",
        "middle_name": "SCRUGGS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "9500660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8955051",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "040015067",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "55051",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "54268",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA MEDICAID",
            "identifier": "6502393",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "9881",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1001971",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Max Motion Physical Therapy, LLC
• Deborah Ariel Maxey
• Katherine Boles Maxey, R.D., L.D.N
• Maxim Habilitation Services, LLC
• Maxim Healthcare Services, Inc.
• Marya Elise Maxwell, LCSW
• May Sun Home Health Nurses, PLLC
• Bonnie E May, CRNA
• Jessica Anastasia May, CRNA
• Kimberly Ann May, N.P.

• Otolaryngology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Otolaryngology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.