Dalton Maples Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA825 Issued in KY

Practice address

1853 Oconnell Blvd
Building 1042
Fort Carson, CO 80913-4055

Phone

(719) 526-9408

NPI assigned

Jul 4, 2006

Last updated

Oct 25, 2012By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/fdbc9673-c618-4425-b458-9d4512be1bb3/

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.

• Independence Park Medical Services Inc

  • Multi-Specialty Clinic/Center
  • Anchorage, AK
  • NPI 1366435273
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1932139748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1853 OCONNELL BLVD",
            "address_2": "BUILDING 1042",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134055",
            "telephone_number": "719-526-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1853 OCONNELL BLVD",
            "address_2": "BUILDING 1042",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134055",
            "telephone_number": "719-526-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAPLES",
        "first_name": "DALTON",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95005153",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Patrick Mahoney, DDS
• John Maitha, PA-C
• Kendell L Mann, MD
• Henry Bass Manning
• Muhammad A. Mansoor, M.D.
• Cheryll Ann Marchalk, RN
• Timothy Arthur Marean, M.D.
• Erin Christine Marion, NP
• Bryan Marot
• Anne G. Marsh, LCSW

• Physician Assistant in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.