Individual provider Active NPI

Maxwell Ofori, MD

  • Emergency Medicine Physician
  • El Paso, TX
National Provider Identifier
1992295604
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
43-0654872 Issued in MO
Practice address
10301 Gateway Blvd W
El Paso, TX 79925-7701
Phone
(915) 595-9000
NPI assigned
May 17, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 43-0654872 MO Primary

Addresses

Primary practice location

10301 Gateway Blvd W
El Paso, TX 79925-7701

Mailing address

1505 18TH St NW
Cleveland, TN 37311-1520
Phone (423) 614-0187

Other practice location 1

1505 18th St NW
Cleveland, TN 37311-1520
Phone (423) 614-0187

Other practice location 2

3635 Vista Ave
Saint Louis, MO 63110-2539
Phone (314) 577-8780

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43-0654872MOMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1992295604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 18TH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373111520",
            "telephone_number": "423-614-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 GATEWAY BLVD W",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799257701",
            "telephone_number": "915-595-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 18th St NW",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "373111520",
            "country_code": "US",
            "telephone_number": "423-614-0187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3635 Vista Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631102539",
            "country_code": "US",
            "telephone_number": "314-577-8780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OFORI",
        "first_name": "MAXWELL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "43-0654872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.