Active NPI
Matthew Lee Maxon, P.T.
- Physical Therapist
- Sioux Falls, SD
National Provider Identifier
1851557557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1430
- Practice address
- 810 E 23Rd St
Sioux Falls, SD 57105-2135 - Phone
- (605) 331-5890
- Fax
- (605) 336-3974
- NPI assigned
- Aug 1, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1430 | SD | Primary |
Addresses
Primary practice location
810 E 23Rd St
Sioux Falls, SD 57105-2135
Mailing address
PO Box 5116
Sioux Falls, SD 57117-5116
Phone (605) 331-5890
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851557557 | Other | SD | RR MEDICARE |
| 5836670 | Medicaid | SD |
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 |
|---|---|---|---|
| 1430 | SD | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic Institute PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Tea, SD
- NPI 1245263326
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255305600000",
"number": "1851557557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5116",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175116",
"telephone_number": "605-331-5890",
"fax_number": "605-336-3974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 E 23RD ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571052135",
"telephone_number": "605-331-5890",
"fax_number": "605-336-3974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXON",
"first_name": "MATTHEW",
"middle_name": "LEE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-01",
"last_updated": "2009-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SD",
"license": "1430",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "1851557557",
"state": "SD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5836670",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.