Individual provider Active NPI

Makayla Esther Maddux, SLP

  • Speech-Language Pathologist
  • Fort Worth, TX
National Provider Identifier
1942670500
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
111879 Issued in TX
Practice address
923 Pennsylvania Ave Ste 100
Fort Worth, TX 76104-2254
Phone
(817) 920-0484
Fax
(817) 920-0068
NPI assigned
Sep 25, 2015
Last updated
Aug 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 111879 TX Primary

Addresses

Primary practice location

923 Pennsylvania Ave Ste 100
Fort Worth, TX 76104-2254

Mailing address

P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151107000064 TX Practitioner - Qualified Speech Language Pathologist 5193035921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Care PLLCGroup PAC ID 7214840867, 363 clinicians

Practice addresses (Care Compare)

923 Pennsylvania Ave
Suite 100
Fort Worth, TX 76104-2254
Phone (817) 920-0484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111879TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Care, P.L.L.C. Current Accepting new patients
Texas Health Care, P.L.L.C. CurrentSince Sep 1, 2015 Accepting new patients
Texas Health Care, P.L.L.C. PastSince Sep 1, 2015 Accepting new patients

Locations

3500 Gaston Ave
Dallas, TX 75246

4300 N Central Expy
Ste 110
Dallas, TX 75206
Phone (214) 823-3333

923 Pennsylvania Ave
Ste 100
Fort Worth, TX 76104
Phone (817) 806-4245

2821 Lackland Rd
Ste 300
Ft Worth, TX 76116
Phone (817) 740-8400

6700 Buenos Aires Dr
North Richlnd Hls, TX 76180
Phone (817) 281-8245

Interoperability endpoints

  • Direct secure messaging: makayla.maddux.p1@direct.thc.nextgenshare.com

Organizations & group practices 3

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": "1443139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1942670500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8400",
            "fax_number": "817-378-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 PENNSYLVANIA AVE STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042254",
            "telephone_number": "817-920-0484",
            "fax_number": "817-920-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDUX",
        "first_name": "MAKAYLA",
        "middle_name": "ESTHER",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-25",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "111879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.