Individual provider Active NPI

Nancy Cheyenne Maddox, LPN

  • Licensed Practical Nurse
  • McMinnville, TN
National Provider Identifier
1811582380
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
93795 Issued in TN
Practice address
3100 Crisp Springs Rd
McMinnville, TN 37110-5238
Phone
(931) 939-5045
NPI assigned
Mar 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 93795 TN Primary

Addresses

Primary practice location

3100 Crisp Springs Rd
McMinnville, TN 37110-5238

Mailing address

3100 Crisp Springs Rd
McMinnville, TN 37110-5238
Phone (931) 939-5045

Other identifiers 1

IdentifierTypeStateIssuer
116111934OtherTNDRIVER LICENSE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
93795TNMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1811582380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 CRISP SPRINGS RD",
            "city": "MCMINNVILLE",
            "state": "TN",
            "postal_code": "371105238",
            "telephone_number": "931-939-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 CRISP SPRINGS RD",
            "city": "MCMINNVILLE",
            "state": "TN",
            "postal_code": "371105238",
            "telephone_number": "931-939-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "NANCY",
        "middle_name": "CHEYENNE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "93795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "116111934",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.