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Deactivated NPI 1801803960 Deactivated / Inactive NPI Male Practitioner

Dr. Jerry Ray Maxwell , DPM

Podiatrist • Edmond, OK

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jerry Maxwell has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 02, 2006
NPI Deactivation Date June 21, 2023
Total Practice Duration ~17 Years of Practice (2006 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Jerry Maxwell, DPM was a registered Podiatrist practicing in Edmond, OK. Throughout an active medical career spanning 17 years, Dr. Maxwell provided care at the practice location at 600 W 15TH ST until profile deactivation on 2023-06-21.

Practice Location & Contact Primary Location

Practice Address

600 W 15th St

Edmond, OK 730133617

Telephone 4053409251
Fax 4053400686
Associated Practice Facility / Clinic
🏢 Steve A. Walker Facility NPI 1457535049

Specialty Benchmarks & Practice Insights

Comparative analytics for Podiatrist in Edmond, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 32.5 Yrs
State Avg: 26.8 Yrs
Regional Practice Density
6 Specialists

Practicing in Edmond, OK (71 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Podiatrist Primary Specialty

NUCC Taxonomy Code: 213E00000X

State License OK 144

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1174555445

Doctor of Podiatric Medicine

NPI 1295768091

Doctor of Podiatric Medicine

NPI 1447484019

Doctor of Podiatric Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 21, 2023

Record deactivated on June 21, 2023

NPI Profile Active January 26, 2012

NPI status registered as active in NPPES database

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Updated Practice Location January 26, 2012

Registered at 600 W 15TH ST, EDMOND, OK 730133617 (Tel: 4053409251)

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Updated Business Mailing Address January 26, 2012

Registered at 600 W 15TH ST, EDMOND, OK 730133617 (Tel: 4053409251)

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Provider Name / Credentials Updated January 26, 2012

Recorded as JERRY MAXWELL, DPM

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 26, 2012

Podiatrist (License #144 in OK)

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Initial NPI Registration & Enumeration August 02, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1801803960
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 02, 2006
Last Update: January 26, 2012
Deactivation Date: June 21, 2023

Mailing Address

600 W 15th St

Edmond, OK 730133617

Phone: 4053409251

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.