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MARISSA LYNNAE MAXHAM PTA
NPI 1205405859
Physical Medicine & Rehabilitation - Pain Medicine in Flora, IL

Active since June 18, 2021
701 SHADWELL AVE, FLORA, IL 62839(618) 662-8361 Get Directions Write a Review

NPPES record last updated: June 18, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Marissa Lynnae Maxham Pta NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARISSA LYNNAE MAXHAM PTA (NPI 1205405859) is an individual pain medicine provider in Flora, Illinois, licensed in Illinois (160008997) and active in the NPI registry since June 2021.

NPPES Registry Identity

NPI1205405859
Entity TypeIndividualFemale
Primary Taxonomy2081P2900X
Provider Legal NameMARISSA LYNNAE MAXHAMCredential: PTA
Location Address701 SHADWELL AVEFlora, IL 62839-2310
Mailing Address702 Shadwell AveFlora, IL 62839-2309 · (618) 842-4138
Phone(618) 662-8361
Sole ProprietorNo
Enumeration DateJune 18, 2021
NPPES CertifiedMay 29, 2021
✔ NPI 1205405859 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2081P2900X
License✔ Licensed in IL · 160008997
Definition
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
Also ListedPhysical Medicine & Rehabilitation · Hospice and Palliative MedicineTaxonomy 2081H0002X · License 160.008997 (IL)
701 SHADWELL AVE, Flora, IL 62839
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Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LARA HEALY OTR
Occupational Therapist
701 SHADWELL AVE
FLORA, IL 62839
Clay County (618) 662-8361
SHELBY CUFFLE
Physical Therapy Assistant
701 SHADWELL AVE
FLORA, IL 62839
Clay County (618) 662-8361
HEATHER ATKINS PTA
Physical Therapy Assistant
701 SHADWELL AVE
FLORA, IL 62839
Clay County (618) 662-8361
PETERSEN HEALTH NETWORK, LLC
Skilled Nursing Facility
701 SHADWELL AVE
FLORA, IL 62839
Clay County (618) 662-8361
KATIE BRIANNA VANBLARICUM
Speech-Language Pathologist
701 SHADWELL AVE
FLORA, IL 62839
Clay County (618) 662-8361
FLORA PAVILION NURSING HOME CENTER, INC
Skilled Nursing Facility
701 SHADWELL AVE
FLORA, IL 62839
Clay County (618) 662-8361
AXIOM GARDENS OF FLORA LLC
Durable Medical Equipment & Medical Supplies
701 SHADWELL AVE
FLORA, IL 62839
Clay County (618) 662-8361
AXIOM GARDENS OF FLORA LLC
Skilled Nursing Facility
701 SHADWELL AVE
FLORA, IL 62839
Clay County (618) 662-8361

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marissa Maxham's NPI number?

The NPI number for Marissa Maxham is 1205405859. It was assigned to this individual provider in the NPPES registry on June 18, 2021.

Where is Marissa Maxham located?

Marissa Maxham practices at 701 Shadwell Ave, Flora, IL 62839. The listed phone number is (618) 662-8361.

What is Marissa Maxham's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.

When was this NPI record last updated?

The NPPES record for Marissa Maxham was last updated on June 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.