Individual provider Active NPI

James Bradley Maddox

  • Family Nurse Practitioner
  • Vestavia HLS, AL
National Provider Identifier
1013475508
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-137720 Issued in AL
Practice address
1940 Stonegate Dr
Vestavia HLS, AL 35242-2539
Phone
(205) 977-9876
NPI assigned
Mar 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-137720 AL Primary

Addresses

Primary practice location

1940 Stonegate Dr
Vestavia HLS, AL 35242-2539

Mailing address

1940 Stonegate Dr
Vestavia HLS, AL 35242-2539
Phone (205) 317-5939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191211003300 AL Practitioner - Nurse Practitioner 5597198127 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Alabama PCGroup PAC ID 9436211463, 42 clinicians

Practice addresses (Care Compare)

1940 Stonegate Dr
Suite 140
Vestavia HLS, AL 35242-2541
Phone (205) 968-3919

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aqua Dermatology of Alabama PC CurrentSince Apr 28, 2021 Accepting new patients
Birmingham Hematology Oncology Assoc LLC PastSince May 25, 2021 Accepting new patients
Jere H. Weaver Past Accepting new patients
Cutaneous Oncology & Surgery Center, LLC PastSince Apr 28, 2021 Accepting new patients

Locations

3368 Highway 280
Ste 200
Alexander City, AL 35010
Phone (256) 329-2197

1401 Edwards Lake Rd
Birmingham, AL 35235
Phone (205) 853-3960

802 Bank St NE
Decatur, AL 35601
Phone (256) 351-1874

407 S 4th St
Gadsden, AL 35901
Phone (256) 546-4236

407 S 4th St
Ste 130
Gadsden, AL 35901

4810 Whitesport Cir SW
Ste 110
Huntsville, AL 35801
Phone (256) 539-2531

1419 Hamric Dr E
Oxford, AL 36203
Phone (256) 241-3242

1940 Stonegate Dr
Vestavia Hls, AL 35242
Phone (205) 592-5077

1940 Stonegate Dr
Ste 140
Vestavia Hls, AL 35242
Phone (205) 968-3919

1940 Stonegate Dr
Ste 130
Vestavia Hls, AL 35242
Phone (205) 451-9481

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1013475508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 STONEGATE DR",
            "city": "VESTAVIA HLS",
            "state": "AL",
            "postal_code": "352422539",
            "telephone_number": "205-317-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 STONEGATE DR",
            "city": "VESTAVIA HLS",
            "state": "AL",
            "postal_code": "352422539",
            "telephone_number": "205-977-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "JAMES",
        "middle_name": "BRADLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-04",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-137720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestavia HLS, AL

Sources for this page

Verify at the official NPI Registry.