James Murray Jeffries III, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

036.131119 Issued in IL

Practice address

4909 N Glen Park Place Rd
Peoria, IL 61614-4676

Phone

(309) 674-7546

Fax

(309) 282-0500

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, IA2 enrollments

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 2

Specialty

Plastic and Reconstructive Surgery

Education

Rutgers New Jersey Medical School, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Soderstrom Dermatology Center S CGroup PAC ID 2062432651, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjeffries@directaddress.net

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.

• Soderstrom Dermatology Center S C

  • Dermatology Physician
  • Peoria, IL
  • NPI 1710931670

  IA

  Medicare reassignment Care Compare group NPD
• Soderstrom Dermatology Center S C

  • Ambulatory Surgical Clinic/Center
  • Peoria, IL
  • NPI 1053362343
  NPD
• Licking Memorial Professional Corporation

  • Durable Medical Equipment & Medical Supplies
  • Newark, OH
  • NPI 1326436510
  NPD (past)
• Plastic Surgical Associates

  • Plastic Surgery Physician
  • Somerville, NJ
  • NPI 1578605176
  NPD (past)

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

• Proctor Community Hospital

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1033116876
  Care Compare affiliation
• Proctor Community Hospital

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1134826894
  Care Compare affiliation

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1073655676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 N GLEN PARK PLACE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144676",
            "telephone_number": "309-674-7546",
            "fax_number": "309-282-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 N GLEN PARK PLACE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144676",
            "telephone_number": "309-674-7546",
            "fax_number": "309-282-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFRIES",
        "first_name": "JAMES",
        "middle_name": "MURRAY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": "036.131119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Ann Jaszarowski, RN, CWOCN
• Muhammad Jawad Javed, M.D.
• JD Nimrick PC
• Heather Jefford, DNP, APN
• Talya Marie Jeffrey, DO
• Charity Thompson Jeffs, CD(DONA)
• Adam Kyle Jelinek, PA-C
• Jene'S LTD Boutique
• Jenecsis Castro-Skoglund SC
• Ann Jenkins, MD

• Plastic and Reconstructive Surgery Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Plastic and Reconstructive Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.