NPIMap

Organization Active NPI

Maxis Medical Services

  • Family Medicine Physician
  • Carbondale, PA
National Provider Identifier
1932287331
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MAXIS MEDICAL SERVICES
Practice address
100 Lincoln Ave
Carbondale, PA 18407-2116
Phone
(570) 281-1315
Fax
(570) 281-1256
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mary Theresa Vautrinot
Title
Chief Executive Officer
Phone
(570) 281-1315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

100 Lincoln Ave
Carbondale, PA 18407-2116

Mailing address

100 Lincoln Ave
Carbondale, PA 18407-2116
Phone (570) 281-1315

National Provider Directory

National Provider Directory
Tax ID family
Maxis Medical Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932287331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LINCOLN AVE",
            "city": "CARBONDALE",
            "state": "PA",
            "postal_code": "184072116",
            "telephone_number": "570-281-1315",
            "fax_number": "570-281-1256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LINCOLN AVE",
            "city": "CARBONDALE",
            "state": "PA",
            "postal_code": "184072116",
            "telephone_number": "570-281-1315",
            "fax_number": "570-281-1256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIS MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAUTRINOT",
        "authorized_official_first_name": "MARY THERESA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "570-281-1315"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.