Individual provider Active NPI

Cynthia Denise Riley Maxwell, NP

  • Family Nurse Practitioner
  • McDonough, GA
National Provider Identifier
1972272144
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN264469 Issued in GA
Practice address
65 Old Jackson Rd
McDonough, GA 30252-3095
Phone
(678) 490-0080
NPI assigned
Sep 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN264469 GA Primary

Addresses

Primary practice location

65 Old Jackson Rd
McDonough, GA 30252-3095

Mailing address

3333 Riverwood Pkwy SE Ste 250
Atlanta, GA 30339-3304
Phone (770) 914-0116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211006002605 GA Practitioner - Nurse Practitioner 3971901844 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aylo Health, LLCGroup PAC ID 8022901925, 112 clinicians

Practice addresses (Care Compare)

65 Old Jackson Rd
McDonough, GA 30252-3095
Phone (770) 914-0116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN264469GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greystone OBGYN PC CurrentSince Dec 6, 2022 Accepting new patients
Aylo Health, LLC CurrentSince Oct 1, 2024 Accepting new patients
Every Woman'S OB-GYN LLC CurrentSince Jun 8, 2022 Accepting new patients
Aylo Health, LLC CurrentSince Oct 1, 2024 Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

3333 Riverwood Pkwy SE
Ste 250
Atlanta, GA 30339
Phone (770) 914-0016

3240 Avalon Blvd
Conyers, GA 30013
Phone (770) 860-1133

1101 Nortec Dr SE
Conyers, GA 30013
Phone (678) 374-7514

65 Old Jackson Rd
McDonough, GA 30252
Phone (678) 490-0080

115 N Park Trl
Ste 119
Stockbridge, GA 30281
Phone (678) 881-0020

145 Eagles Walk
Ste A
Stockbridge, GA 30281
Phone (770) 389-3855

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1972272144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 RIVERWOOD PKWY SE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393304",
            "telephone_number": "770-914-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 OLD JACKSON RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302523095",
            "telephone_number": "678-490-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "CYNTHIA",
        "middle_name": "DENISE RILEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN264469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

Verify at the official NPI Registry.