Individual provider Active NPI

Brenda Maxson, LPN

  • Licensed Practical Nurse
  • Potsdam, NY
National Provider Identifier
1902266307
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
232836-1 Issued in NY
Practice address
56 Market St
Potsdam, NY 13676-1747
Phone
(315) 256-4065
NPI assigned
Feb 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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 232836-1 NY Primary

Addresses

Primary practice location

56 Market St
Potsdam, NY 13676-1747

Mailing address

9 Balmat Fowler Rd
Gouverneur, NY 13642-3351
Phone (315) 287-7697

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
232836-1NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services of Northern New York 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.

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1902266307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BALMAT FOWLER RD",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136423351",
            "telephone_number": "315-287-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 MARKET ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761747",
            "telephone_number": "315-256-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXSON",
        "first_name": "BRENDA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "232836-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potsdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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.