NPIMap

Organization Active NPI

Maxim Healthcare Services, Inc.

  • Home Health Agency
  • Newport News, VA
National Provider Identifier
1942395736
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
EXEMPT Issued in VA
Legal business name
MAXIM HEALTHCARE SERVICES, INC.
Practice address
11818 Rock Landing Dr Ste 200
Newport News, VA 23606-4230
Phone
(797) 595-8822
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Authorized official

Name
Mr. David Kowalczyk
Title
Controller
Phone
(410) 910-1500

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Continence Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WC2100X EXEMPT VA
Home Health Agency 251E00000X EXEMPT VA Primary
Personal Care AttendantGroup: 193200000X MULTI-SPECIALTY GROUP 3747P1801X EXEMPT VA
Respite Care 385H00000X EXEMPT VA

Addresses

Primary practice location

11818 Rock Landing Dr Ste 200
Newport News, VA 23606-4230

Mailing address

7227 Lee Deforest Dr.
Columbia, MD 21046

Other practice location 1

739 Thimble Shoals Blvd
Suite 1002A
Newport News, VA 23606-3562
Phone (757) 595-8822

Other identifiers 2

IdentifierTypeStateIssuer
010309085MedicaidVA
010316685MedicaidVA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D1046108Maxim Healthcare Services, Inc11818 Rock Landing Drive Suite 200, Newport News, VA 23606Certificate of waiverSep 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Maxim Healthcare Servise337 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 10

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

7227 Lee Deforest Dr
Columbia, MD 21046
Phone (410) 910-9073

11818 Rock Landing Dr
Ste 200
Newport News, VA 23606
Phone (797) 595-8822

739 Thimble Shoals Blvd
Ste 1002A
Newport News, VA 23606
Phone (757) 595-8822

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599696000000",
    "number": "1942395736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 LEE DEFOREST DR.",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11818 ROCK LANDING DR STE 200",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064230",
            "telephone_number": "797-595-8822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "739 Thimble Shoals Blvd",
            "address_2": "Suite 1002A",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236063562",
            "country_code": "US",
            "telephone_number": "757-595-8822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "410-910-1500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163WC2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Continence Care",
            "state": "VA",
            "license": "EXEMPT",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "VA",
            "license": "EXEMPT",
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "VA",
            "license": "EXEMPT",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "VA",
            "license": "EXEMPT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010309085",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010316685",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.