Individual provider Active NPI

James Alvin Bruce Jr., MD

  • Ophthalmology Physician
  • Jackson, MS
National Provider Identifier
1114020906
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
05768 Issued in MS
Practice address
2500 Lakeland Dr
Ste a
Jackson, MS 39232
Phone
(601) 939-0079
Fax
(601) 939-6823
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 05768 MS Primary

Addresses

Primary practice location

2500 Lakeland Dr
Ste a
Jackson, MS 39232

Mailing address

5310 Highway 25
Ste 5
Flowood, MS 39232-6148
Phone (601) 939-0079

Other identifiers 1

IdentifierTypeStateIssuer
00015790MedicaidMS

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

LicenseStateTypeSpecialty
05768MSMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Consultants PA Past Accepting new patients
Laura E McCalop DO LLC Ophthalmology 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1114020906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 HIGHWAY 25",
            "address_2": "STE 5",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392326148",
            "telephone_number": "601-939-0079",
            "fax_number": "601-939-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 LAKELAND DR",
            "address_2": "STE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39232",
            "telephone_number": "601-939-0079",
            "fax_number": "601-939-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "JAMES",
        "middle_name": "ALVIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "05768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00015790",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.