MAXIM MCKIBBEN (NPI# 1598022089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1598022089 |
Entity Type | Individual |
Full Name | MAXIM MCKIBBEN |
Credential | MD |
Practice Address |
1023 Edgehill Rd S Charlotte NC 28207-1829 |
Mailing Address |
Po Box 19305 Charlotte NC 28219-9305 |
Practice Telephone | 7043558686 |
Enumeration Date | 2012-04-20 |
Last Update Date | 2020-09-25 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208800000X | Urology | 2018-00434 | NC | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
441 Mcalister Rd, Ste 1200, Lincolnton, NC 280924126 | 9802126200 | |
1021 Morehead Medical Dr, Ste 6100, Charlotte, NC 282042990 | 9804422000 | |
1350 S Kings Dr, Charlotte, NC 282072134 | 7044461255 |
Street Address |
1023 EDGEHILL RD S |
City | CHARLOTTE |
State | NC |
Zip Code | 28207-1829 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972542298 | Chris Teigland | Urology | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2006-06-05 |
1588272785 | Kathryn Barnes | Nurse Practitioner | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2020-07-14 |
1932739372 | Ava Opalinski | Nurse Practitioner | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2020-01-24 |
1033763537 | Dallas Banner | Nurse Practitioner | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2019-08-01 |
1326528548 | Marie Barkley | Physician Assistant | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2018-08-16 |
1679073332 | Abby Looper | Physician Assistant | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2018-02-19 |
1972920684 | Jamie Vano | Nurse Practitioner | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2014-03-20 |
1134558083 | Savanna Watkins | Physician Assistant | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2013-11-01 |
1265866990 | Jaclyn Mieczkowski | Nurse Practitioner | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2013-08-29 |
1558655936 | Manish Patel | Urology | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2011-06-03 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
Find all providers in zip 28207 |
Taxonomy Code | 208800000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Urology |
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942833678 | Joshua Daniel Howell | Urology | 10650 Park Rd Ste 320, Charlotte, NC 28210-8543 | 2020-02-21 |
1427563725 | Hifu Prostate Services, LLC | Urology | 4108 Park Rd Ste 205, Charlotte, NC 28209-2260 | 2017-12-08 |
1689618225 | Daniel Lee Watson | Urology | 325 Hawthorne Ln Ste 300, Charlotte, NC 28204-2433 | 2006-06-15 |
1972542298 | Chris Teigland | Urology | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2006-06-05 |
1306832696 | Todd Douglas Cohen | Urology | 12610 N Community House Rd Ste 100, Charlotte, NC 28277-3892 | 2005-09-22 |
1881222669 | Charles Ellis | Urology | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2020-03-29 |
1902366222 | Samuel J Ivan | Urology | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2019-03-22 |
1487034146 | Daniel Edwards | Urology | 1021 Morehead Medical Dr, Ste 6100, Charlotte, NC 28204-2990 | 2015-06-08 |
1295008324 | Justin Matulay | Urology | 101 E W T Harris Blvd, Ste 5500, Charlotte, NC 28262-3485 | 2012-02-21 |
1558655936 | Manish Patel | Urology | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2011-06-03 |
Find all providers in CHARLOTTE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.