Active NPI
Jennifer M Maddocks, MSPT
- Physical Therapist
- Cary, NC
National Provider Identifier
1962418525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8277
- Practice address
- 3701 NW Cary Parkway
Suite 301
Cary, NC 27513 - Phone
- (919) 388-0111
- Fax
- (919) 388-8668
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 8277 | NC | Primary |
Addresses
Primary practice location
3701 NW Cary Parkway
Suite 301
Cary, NC 27513
Mailing address
3701 NW Cary Parkway
Suite 301
Cary, NC 27513
Phone (919) 388-0111
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3210671 | Other | NC | AETNA HMO |
| 6698131 | Other | NC | GHI |
| 836264 | Other | NC | UHC ACN MPN |
| 5004734 | Other | NC | AETNA PPO |
| 7360555 | Other | NC | UHC ACN MPN |
| 079C2 | Other | NC | BCBS |
Other names 1
- Jennifer Michaud
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8277 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962418525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3701 NW CARY PARKWAY",
"address_2": "SUITE 301",
"city": "CARY",
"state": "NC",
"postal_code": "27513",
"telephone_number": "919-388-0111",
"fax_number": "919-388-8668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 NW CARY PARKWAY",
"address_2": "SUITE 301",
"city": "CARY",
"state": "NC",
"postal_code": "27513",
"telephone_number": "919-388-0111",
"fax_number": "919-388-8668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDOCKS",
"first_name": "JENNIFER",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "8277",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "3210671",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "6698131",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC ACN MPN",
"identifier": "836264",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "5004734",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC ACN MPN",
"identifier": "7360555",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "079C2",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "MICHAUD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.