JOHN C MAYNARD (NPI# 1730180878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730180878 |
| Entity Type | Individual |
| Full Name | JOHN C MAYNARD |
| Credential | MD |
| Practice Address |
612 Roxbury Rd Rockford IL 61107-5089 |
| Practice Telephone | 8152278300 |
| Practice Fax Number | 8152278301 |
| Mailing Telephone | 8152278300 |
| Mailing Fax Number | 8152278301 |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2011-04-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
036066422 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036066422 | 05 | |
| IL | RAILROAD MEDICARE | P00605020 | 01 |
| IL | BCBS | 1616108 | 01 |
| WI | 30525600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275157539 | John Christopher Maynard | Nurse Practitioner | 151 Sammons Ln, Forest Hills, KY 41527-8307 | 2020-06-02 |
| 1841636693 | John Calahan Maynard | Chiropractor | 8922 South Memorial Drive, Tulsa, OK 74133 | 2013-05-21 |
| 1144464587 | John F Maynard | Urology | Metacomet Office Park, 450 Veterans Parkway, East Providence, RI 02914 | 2009-04-29 |
| 1942464813 | John Nathan Maynard | Physician Assistant | 630 W 34th St Ste 301, Austin, TX 78705-1229 | 2008-07-10 |
| 1700894656 | John Wesley Maynard Jr. | Dentist | 1902 Market St, Camp Hill, PA 17011 | 2006-08-04 |
| 1578017877 | John Maynard | Physical Therapist | 214 Saint James Ave, Suite 140b, Goose Creek, SC 29445-2974 | 2016-08-04 |
| 1306116421 | John Ryan Maynard | Physician Assistant | 2826 Randolph Rd, Charlotte, NC 28211-1386 | 2012-01-05 |
| 1679867238 | John S Maynard | Psychologist | 249 Wilson Dr, Suite 5, Boone, NC 28607-8781 | 2011-06-01 |
| 1386803484 | John Tyson Maynard | Chiropractor | 411 Stambaugh Ave, Sharon, PA 16146-4125 | 2008-06-03 |
| Street Address |
612 ROXBURY RD |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-5089 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104827427 | James Stim | Internal Medicine | 612 Roxbury Rd, Rockford, IL 61107-5089 | 2005-08-09 |
| 1336768662 | Jessica Weiland | Nurse Practitioner | 612 Roxbury Rd, Rockford, IL 61107-5089 | 2020-04-16 |
| 1518433564 | Laquisha M Thompson | Internal Medicine | 612 Roxbury Rd, Rockford, IL 61107-5089 | 2018-10-17 |
| 1063993731 | Lilia Avila | Nurse Practitioner | 612 Roxbury Rd, Rockford, IL 61107-5089 | 2018-08-22 |
| 1326526716 | Muamer Mulasmajic | Internal Medicine | 612 Roxbury Rd, Rockford, IL 61107-5089 | 2018-07-30 |
| 1598216657 | Stephanie Michelle Gile | Nurse Practitioner | 612 Roxbury Rd, Rockford, IL 61107-5089 | 2016-10-24 |
| 1992961593 | Charlene D Murdakes | Internal Medicine | 612 Roxbury Rd, Rockford, IL 61107-5089 | 2008-08-03 |
| 1336326388 | Rna of Rockford, LLC | Internal Medicine | 612 Roxbury Rd, Rockford, IL 61107 | 2008-01-22 |
| 1043418908 | Nephrology Associates of Northern Illinois Ltd | Internal Medicine | 612 Roxbury Rd, Rockford, IL 61107-5089 | 2007-07-03 |
| 1699715706 | Jacqueline G May | Registered Nurse | 612 Roxbury Rd, Rockford, IL 61107-5089 | 2006-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306041918 | Talal Mahmood | Internal Medicine | 6940 Villagreen Vw, Rockford, IL 61107-5605 | 2007-06-15 |
| 1821016791 | Joanna M Niemiec | Internal Medicine | 612 Roxbury Road, Rockford, IL 61107-5089 | 2006-07-18 |
| 1295753176 | Northern Illinois Nephrology, S.c | Internal Medicine | 1340 Charles St Ste 400, Rockford, IL 61104-2200 | 2006-07-18 |
| 1104827427 | James Stim | Internal Medicine | 612 Roxbury Rd, Rockford, IL 61107-5089 | 2005-08-09 |
| 1518433564 | Laquisha M Thompson | Internal Medicine | 612 Roxbury Rd, Rockford, IL 61107-5089 | 2018-10-17 |
| 1326526716 | Muamer Mulasmajic | Internal Medicine | 612 Roxbury Rd, Rockford, IL 61107-5089 | 2018-07-30 |
| 1861816167 | Kidney Care Center Rockford LLC | Internal Medicine | 6940 Villagreen Vw, Rockford, IL 61107-5605 | 2014-02-07 |
| 1558593095 | Krishna K R Manda | Internal Medicine | 6940 Villagreen Vw, Rockford, IL 61107-5605 | 2009-08-18 |
| 1992961593 | Charlene D Murdakes | Internal Medicine | 612 Roxbury Rd, Rockford, IL 61107-5089 | 2008-08-03 |
| 1336326388 | Rna of Rockford, LLC | Internal Medicine | 612 Roxbury Rd, Rockford, IL 61107 | 2008-01-22 |
| Find all providers in ROCKFORD | ||||
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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.