Active NPI
James Ebbert Marvel, MD
- Orthopaedic Surgery Physician
- Quitman, TX
National Provider Identifier
1043248677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- J0996
- Practice address
- 108 Parker St
Ste 400
Quitman, TX 75783-2102 - Phone
- (903) 763-6144
- Fax
- (903) 763-6146
- NPI assigned
- Jun 30, 2006
- Last updated
- Jan 8, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | J0996 | TX | Primary |
Addresses
Primary practice location
108 Parker St
Ste 400
Quitman, TX 75783-2102
Mailing address
PO Box 9477
Tyler, TX 75711-9477
Phone (903) 594-2450
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200044978 | Other | MEDICARE RR | |
| 103185804 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J0996 | TX | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Arkansas Clinic, PA | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Quitman, TX
- NPI 1639467384
-
dba NEA Clinic
- Multi-Specialty Clinic/Center
- Jonesboro, AR
- NPI 1376517177
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231372800000",
"number": "1043248677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9477",
"city": "TYLER",
"state": "TX",
"postal_code": "757119477",
"telephone_number": "903-594-2450",
"fax_number": "903-509-0493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 PARKER ST",
"address_2": "STE 400",
"city": "QUITMAN",
"state": "TX",
"postal_code": "757832102",
"telephone_number": "903-763-6144",
"fax_number": "903-763-6146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARVEL",
"first_name": "JAMES",
"middle_name": "EBBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2009-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "TX",
"license": "J0996",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "200044978",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103185804",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Quitman, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.