JEAN L MAXWELL (MS RD) – Registered Dietitian, NPI 1609929108
Registered Dietitian
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
166 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in VA
Provider Addresses for JEAN L MAXWELL (MS RD)
2800 Godwin Blvd
Suffolk, VA 234348038
Phone: (757) 934-4559
Type: Location
1112 Jensen Dr Ste 109
Virginia Beach, VA 234515883
Phone: (757) 589-4293
Fax: (833) 740-4130
Type: Location
256 PORTVIEW AVE APT B
NORFOLK, VA 235031520
Phone: (757) 589-4293
Type: Mailing
Sentara Obici Hospital, 2800, Godwin Boulevard, Red Top, Suffolk, Suffolk (city), Virginia, 23434, United States
SUFFOLK, VA 234348038
Phone: (757) 934-4559
Type: Location
1408, Longstreet Lane, Suffolk, Virginia, 23437, United States
SUFFOLK, VA 234379621
Phone: (757) 589-4293
Type: Mailing
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: 2007-04-11
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070411000204 | I | Registered Dietitian Or Nutrition Professional | VA | TBD |
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.
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 23434)
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