Individual provider Active NPI

William A. James, M.D.

  • Internal Medicine Physician
  • Rives, TN
National Provider Identifier
1063494508
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD17408 Issued in TN
Practice address
4772 Will Dickerson Rd
Rives, TN 38253-3163
Phone
(731) 536-1100
NPI assigned
Nov 18, 2005
Last updated
Sep 7, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME79994 FL
Internal Medicine Physician 207R00000X MD17408 TN Primary
Internal Medicine Physician 207R00000X ME79994 FL
Internal Medicine Physician 207R00000X 26231 KY

Addresses

Primary practice location

4772 Will Dickerson Rd
Rives, TN 38253-3163

Mailing address

4772 Will Dickerson Rd
Rives, TN 38253-3163
Phone (731) 536-1100

Other identifiers 5

IdentifierTypeStateIssuer
3706440MedicaidTN
91547OtherFLBCBS
3000283OtherBLUE CROSS
4080616OtherAETNA
7800781OtherFLAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041027000259 TN Practitioner - Emergency MedicinePractitioner - Internal Medicine 9638131253 Reassigns benefits to 12 organizations
Practice locations: Union City, TN

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness Ambulatory Care Inc.Group PAC ID 2163703901, 5 clinicians

Practice addresses (Care Compare)

412 Citico St
Knoxville, TN 37921-5811
Phone (865) 522-0661

58 Carriage House Dr
Jackson, TN 38305-3933
Phone (731) 660-0880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD17408TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BHG Xxxi, LLC CurrentSince May 1, 2021 Accepting new patients
Lauderdale Community Hospital LLC CurrentSince Jan 20, 2021 Accepting new patients
DRD Management, Inc CurrentSince May 1, 2021 Accepting new patients
Lauderdale Community Hospital LLC Current Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Apr 13, 2015 Accepting new patients
Vcphcs VIII, LLC CurrentSince May 1, 2021 Accepting new patients
Vcphcs Xvii, LLC CurrentSince May 1, 2021 Accepting new patients
Vcphcs Xxi, LLC CurrentSince May 1, 2021 Accepting new patients
BHG Xxvii, LLC CurrentSince May 1, 2021 Accepting new patients
Vcphcs Xix, LLC CurrentSince May 14, 2021 Accepting new patients
Wellness Ambulatory Care Inc. Current Accepting new patients
Vcphcs IX, LLC CurrentSince May 1, 2021 Accepting new patients
Wellness Ambulatory Care Inc. CurrentSince Sep 11, 2021 Accepting new patients
Wellness Ambulatory Care Inc. CurrentSince Sep 11, 2021 Accepting new patients
Lauderdale Community Hospital LLC CurrentSince Jan 20, 2021 Accepting new patients
Dyersburg HBP Medical Group LLC Emergency Medicine Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
DRD Management, Inc Past Accepting new patients
Baptist Memorial Hospital- Union City Inc Past Accepting new patients
Wellness Ambulatory Care Inc. PastSince Feb 7, 2021 Accepting new patients
Wellness Ambulatory Care Inc. PastSince Feb 7, 2021 Accepting new patients
4MD2 Physician Services of Fort Walton Beach LLC Emergency Medicine Past Accepting new patients
Cah Acquisition Company 11 LLC PastSince Apr 21, 2018 Accepting new patients
Paula Vassar Inc Past Accepting new patients
Mt. Pelia Emergency Physicians Emergency Medicine Past Accepting new patients
Pauker Inpatient Services Internal Medicine Past Accepting new patients

Locations

1202 S James M Campbell Blvd
Ste 7A
Columbia, TN 38401
Phone (931) 381-0020

400 E Tickle St
Dyersburg, TN 38024
Phone (731) 285-2410

640 US Highway 51 Byp E
Ste M
Dyersburg, TN 38024
Phone (731) 285-6535

58 Carriage House Dr
Ste B
Jackson, TN 38305
Phone (731) 660-0880

412 Citico St
Knoxville, TN 37921
Phone (865) 522-0661

626 Bernard Ave
Knoxville, TN 37921
Phone (865) 522-0161

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261

1734 Madison Ave
Memphis, TN 38104
Phone (901) 722-9420

2165 Spicer Cv
Ste 5
Memphis, TN 38134
Phone (901) 372-7878

2410 Charlotte Ave
Nashville, TN 37203
Phone (615) 321-2575

342 22nd Ave N
Nashville, TN 37203
Phone (615) 327-2001

326 Asbury Ave
Ripley, TN 38063
Phone (731) 221-2200

326 Asbury Ave
Ste 104
Ripley, TN 38063
Phone (731) 221-2200

340 Asbury Ave
Ripley, TN 38063
Phone (731) 221-2200

85 Harrison St
Savannah, TN 38372
Phone (731) 925-2767

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

5001 Spring Vly
Ste 600E
Dallas, TX 75244

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/lauderd-6f671ec9

Organizations & group practices 27

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.

View all 27

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1063494508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4772 WILL DICKERSON RD",
            "city": "RIVES",
            "state": "TN",
            "postal_code": "382533163",
            "telephone_number": "731-536-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4772 WILL DICKERSON RD",
            "city": "RIVES",
            "state": "TN",
            "postal_code": "382533163",
            "telephone_number": "731-536-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "WILLIAM",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME79994",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD17408",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME79994",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "26231",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3706440",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "91547",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3000283",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4080616",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7800781",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.