Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicholas Maddox, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1609584960

Nicholas Maddox, FNP-BC is a Nurse Practitioner in Jefferson, North Carolina. Qualified in 2022, 4 years ago. Practices with Pai Participant 1 LLC, a 168-clinician group and accepts Medicare assignment. Licensed in North Carolina and Virginia.

Years since qualifying
4
Licensed in
NC, VA
In the registry since
2022
Specialties on file
2
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

540 Waugh St
Jefferson, NC 28640-9034
Phone: (336) 246-5581
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 5021560 (NC)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence 0024185720 (VA)

Record details

NPI number1609584960
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedNovember 7, 2022
Last updated in NPPESApril 12, 2025
Certification dateApril 12, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Pai Participant 1 Llc — 168 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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