Active NPI
Maximo C Kiok, MD
- Neurology Physician
- Monroe, LA
National Provider Identifier
1851359244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 15200R
- Practice address
- 920 Oliver Rd # L
Monroe, LA 71201-5702 - Phone
- (318) 361-2161
- Fax
- (318) 812-6055
- NPI assigned
- May 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 11562 | ND | |
| Neurology Physician | 2084N0400X | 15200R | LA | Primary |
Addresses
Primary practice location
920 Oliver Rd # L
Monroe, LA 71201-5702
Mailing address
130 Desiard St Ste 355
Monroe, LA 71201-7363
Phone (318) 998-3426
Other practice location 1
20 Burdick Expy W
Minot, ND 58701-4498
Phone (701) 857-5421
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1461113 | Medicaid | LA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15200R | LA | MD | Neurology Physician |
| 11562 | ND | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thibodaux Regional Network Development Corporation | Current | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Locations
602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Thibodaux, LA
- NPI 1285658310
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582243200000",
"number": "1851359244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 DESIARD ST STE 355",
"city": "MONROE",
"state": "LA",
"postal_code": "712017363",
"telephone_number": "318-998-3426",
"fax_number": "318-812-6603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 OLIVER RD # L",
"city": "MONROE",
"state": "LA",
"postal_code": "712015702",
"telephone_number": "318-361-2161",
"fax_number": "318-812-6055"
}
],
"practiceLocations": [
{
"address_1": "20 Burdick Expy W",
"address_purpose": "LOCATION",
"city": "Minot",
"state": "ND",
"postal_code": "587014498",
"country_code": "US",
"telephone_number": "701-857-5421",
"fax_number": "701-857-5427",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIOK",
"first_name": "MAXIMO",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2020-02-21",
"certification_date": "2020-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "ND",
"license": "11562",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "LA",
"license": "15200R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1461113",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.