Individual provider Active NPI

Derek Kyle Maxson, D.C.

  • Chiropractor
  • Sugar Land, TX
National Provider Identifier
1891885711
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
10038 Issued in TX
Practice address
9907 S Highway 6
Suite 360
Sugar Land, TX 77498-4995
Phone
(832) 328-0303
Fax
(832) 328-0404
NPI assigned
Oct 13, 2006
Last updated
Jun 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 10038 TX Primary

Addresses

Primary practice location

9907 S Highway 6
Suite 360
Sugar Land, TX 77498-4995

Mailing address

9907 S Highway 6 Ste 360
Sugar Land, TX 77498-4997
Phone (832) 328-0303

Other identifiers 2

IdentifierTypeStateIssuer
612980OtherTXMEDICARE PTAN
608318OtherTXBCBS

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

LicenseStateTypeSpecialty
10038TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Derek K Maxson Chiropractor PastSince Jan 1, 1990 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244764800000",
    "number": "1891885711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9907 S HIGHWAY 6 STE 360",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774984997",
            "telephone_number": "832-328-0303",
            "fax_number": "832-328-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9907 S HIGHWAY 6",
            "address_2": "SUITE 360",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774984995",
            "telephone_number": "832-328-0303",
            "fax_number": "832-328-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXSON",
        "first_name": "DEREK",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2009-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "612980",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "608318",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

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

Verify at the official NPI Registry.