Active NPI
David Joel Maxey, LCSW
- Clinical Social Worker
- Knoxville, TN
National Provider Identifier
1801895305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LSW3801
- Practice address
- 4741 N Broadway St
Knoxville, TN 37918-1793 - Phone
- (865) 804-4479
- Fax
- (865) 687-7911
- NPI assigned
- Jul 18, 2005
- Last updated
- Jun 29, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LSW3801 | TN | Primary |
Addresses
Primary practice location
4741 N Broadway St
Knoxville, TN 37918-1793
Mailing address
PO Box 5558
Knoxville, TN 37928-0558
Phone (865) 804-4479
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3924830 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSW3801 | TN | MD | Clinical Social Worker |
| 3801 | TN | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309305600000",
"number": "1801895305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5558",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379280558",
"telephone_number": "865-804-4479",
"fax_number": "865-687-7911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4741 N BROADWAY ST",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379181793",
"telephone_number": "865-804-4479",
"fax_number": "865-687-7911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXEY",
"first_name": "DAVID",
"middle_name": "JOEL",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-18",
"last_updated": "2011-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "LSW3801",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3924830",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.