James Ivey, MD
Individual provider Active NPI Family Medicine Physician · Trenton, FL
NPI 1093740169 · NPPES record last updated Sep 6, 2011
Key facts
- NPI
- 1093740169
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- ME0011709 (FL)
- Practice address
- 911 S Main St
Trenton, FL 32693-3239 - Phone
- (352) 463-2374
- Fax
- (352) 463-4507
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0011709 | FL | MD | Family Medicine Physician |
| 11709 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bluestone Physician Services Southeast LLC | Family Medicine | Past | Accepting new patients |
| Rural Medical Associates Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME0011709 | FL | Yes |
Addresses
Primary practice location
911 S Main St
Trenton, FL 32693-3239
Mailing address
911 S Main St
Trenton, FL 32693-3239
Phone (352) 463-2374
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME0011709 | Other | FL | MEDICAL LICENSE |
| 12785 | Other | FL | BC |
| 055771400 | Medicaid | FL |
Other providers in Trenton, FL
- Kimberly Carpenter Herring
- Savannah Hickman
- Home Respiratory Solutions, Inc.
- Hometown Healthcare and Pediatrics LLC
- Lillian E Hummer
- Camille Jefferson
- Sujin Ju
- Susan Marlene Kennedy
- Kaila M King
- Curtis Kirby
All providers in Trenton, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.