Provider Demographics
NPI:1144106121
Name:MAX-WELL PRIMARY CARE LLC
Entity type:Organization
Organization Name:MAX-WELL PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLI MAXWELL
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLI MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, NP-C
Authorized Official - Phone:913-662-0043
Mailing Address - Street 1:15604 PINEHURST DR STE 4
Mailing Address - Street 2:
Mailing Address - City:BASEHOR
Mailing Address - State:KS
Mailing Address - Zip Code:66007-8234
Mailing Address - Country:US
Mailing Address - Phone:913-662-0043
Mailing Address - Fax:913-662-0043
Practice Address - Street 1:15604 PINEHURST DR STE 4
Practice Address - Street 2:
Practice Address - City:BASEHOR
Practice Address - State:KS
Practice Address - Zip Code:66007-8234
Practice Address - Country:US
Practice Address - Phone:913-662-0043
Practice Address - Fax:913-662-0043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty