MADDISON RAE MAXEDON (APRN) – Nurse Practitioner, NPI 1629862982

MADDISON RAE MAXEDON (APRN) is a healthcare provider. based in Mt zion, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 209.032157 (IL). The NPI Number for MADDISON RAE MAXEDON (APRN) is 1629862982

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
MADDISON RAE MAXEDON (APRN)
NPI
1629862982
Phone
Not provided
Address
104 E ASHLAND AVE
Enumeration Date
9 April 2025
Last Update Date
9 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2178642665
Graduation Year
2022 (4 years ago)
PAC ID
6305345521
Group Practice PAC ID
4981844289
Professional Enrollment ID
I20250815001342
Address ID
IL625491271MT104XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for MADDISON RAE MAXEDON (APRN)

  • 104 E ASHLAND AVE

    MT ZION, IL 625491271

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250815001342INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62549)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4981844289View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIL
Orthopedic Surgery, Plastic And Reconstructive SurgeryIL
-IL
Nurse PractitionerIL
Physical Therapist In Private PracticeIL
Orthopedic SurgeryIL
P O D I A T R YIL
Nurse PractitionerIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

What is the standard ID for MADDISON RAE MAXEDON (APRN) in the U.S.?
In the U.S., MADDISON RAE MAXEDON (APRN) is identified by NPI 1629862982.
Is MADDISON RAE MAXEDON (APRN) currently accepting referrals based on NPI status?
Registry metadata lists MADDISON RAE MAXEDON (APRN) as active.
What does the directory say MADDISON RAE MAXEDON (APRN) does?
Insurance directories may phrase it differently, but here MADDISON RAE MAXEDON (APRN) maps to Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to MADDISON RAE MAXEDON (APRN)?
The directory associates MADDISON RAE MAXEDON (APRN) with Mt Zion, Illinois. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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