NPIMap

Individual provider Active NPI

James Michael Davis, MD

  • Orthopaedic Surgery Physician
  • Herrin, IL
National Provider Identifier
1063516797
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Practice address
510 Lincoln Drive
Southern Orthopedic Associates SC
Herrin, IL 62948
Phone
(618) 997-6800
Fax
(618) 998-9124
NPI assigned
Sep 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X IL Primary

Addresses

Primary practice location

510 Lincoln Drive
Southern Orthopedic Associates SC
Herrin, IL 62948

Mailing address

510 Lincoln Drive
Southern Orthopedic Associates SC
Herrin, IL 62948
Phone (618) 997-6800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100419000047 IL Practitioner - Orthopedic Surgery 7416932140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Tulane University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Orthopedic Associates SCGroup PAC ID 8921095514, 29 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1101 W Diann LN
Carbondale, IL 62901-5339
Phone (618) 997-6800

1104 W Main St
Benton, IL 62812-1565
Phone (618) 439-3399

2421 W Main St
Suite a
Carbondale, IL 62901-1039
Phone (618) 529-3201

326 E Main St
West Frankfort, IL 62896-2402
Phone (618) 937-6200

510 Lincoln Dr
Herrin, IL 62948-3774

510 Lincoln Dr
Herrin, IL 62948-6334
Phone (618) 997-6800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.56 of 100Reported as group
Quality
83.23
Promoting interoperability
100
Improvement activities
40
Cost
75.4

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement60
Knee replacement132
Lower limb (leg) arthroscopy (minimally invasive joint repair)18
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Orthopedic Associates SC Orthopaedic Surgery CurrentSince Oct 16, 2000 Accepting new patients
Southern Illinois Medical Services, NFP PastSince Jun 30, 2017 Accepting new patients

Locations

1101 W Diann Ln
Carbondale, IL 62901
Phone (618) 997-6800

305 W Jackson St
Ste 400
Carbondale, IL 62901
Phone (618) 351-4972

510 Lincoln Dr
Herrin, IL 62948
Phone (618) 997-3100

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jdavis420498@direct.deaconess.com
  • Direct secure messaging: jdavis55@yourcarecommunity.org

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063516797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 LINCOLN DRIVE",
            "address_2": "SOUTHERN ORTHOPEDIC ASSOCIATES SC",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "62948",
            "telephone_number": "618-997-6800",
            "fax_number": "618-998-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 LINCOLN DRIVE",
            "address_2": "SOUTHERN ORTHOPEDIC ASSOCIATES SC",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "62948",
            "telephone_number": "618-997-6800",
            "fax_number": "618-998-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

Verify at the official NPI Registry.