Ian Maxwell

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT031566 Issued in PA

Practice address

1608 Walnut St Ste 200
Philadelphia, PA 19103-5426

Phone

(155) 458-7172

Fax

(215) 545-9355

NPI assigned

Jun 22, 2023

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

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cloudline Physical Therapy LLCGroup PAC ID 6305266222, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cloudline Physical Therapy LLC

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1457968448
  Medicare reassignment Care Compare group NPD
• Orthopedic and Sports Physical Therapy Services, Inc.

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1588661235
  Medicare reassignment NPD
• Progress Physical Therapy LLC

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1164851085
  Medicare reassignment NPD

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1851077127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 WALNUT ST STE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191035426",
            "telephone_number": "155-458-7172",
            "fax_number": "215-545-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "IAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT031566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Maxwell
• Christinea Victoria Maxwell
• Colleen Maxwell, PHD
• Courtney Ann Maxwell, CRNP, CPNP-AC
• Elizabeth Clabby Maxwell, M.D.
• Judith Maxwell
• Kara Noelle Maxwell, M.D.
• Lynn G Maxwell, M.D.
• Russell John Luke Maxwell, MD
• Terri L Maxwell, RN

• Physical Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.