Individual provider Active NPI

James Leroy Springer, MD

  • Family Medicine Physician
  • Shelbyville, IN
National Provider Identifier
1194701359
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01065737A Issued in IN
Practice address
104 Foxborough Run
Shelbyville, IN 46176
Phone
(317) 512-2711
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD17476 OR
Family Medicine Physician 207Q00000X 01065737A IN Primary

Addresses

Primary practice location

104 Foxborough Run
Shelbyville, IN 46176

Mailing address

104 Foxborough Run
Shelbyville, IN 46176-2879

Other practice location 1

8177 Clearvista Pkwy
Indianapolis, IN 46256-1662
Phone (317) 621-7801

Other identifiers 7

IdentifierTypeStateIssuer
032073MedicaidOR
1407812365OtherORNBMC GROUP NPI NUMBER
P00143357OtherORRR MEDICARE PTAN NUMBER
R0000WFBTVOtherORMEDICARE GROUP PIN NUMBER
201195760MedicaidIN
CB3544OtherORRR MEDICARE GROUP NUMBER
P01307618OtherINMEDICARE RR PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20050201000405 IN Practitioner - Family Practice 7618945312 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01065737AINMDFamily Medicine Physician
MD17476ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Multispecialty Associates CurrentSince Mar 30, 2020 Accepting new patients
Major Multispecialty Associates Family Medicine CurrentSince Mar 30, 2020 Accepting new patients
North Bend Medical Center Inc Past Accepting new patients

Locations

1626 E State Road 44
Ste A
Shelbyville, IN 46176
Phone (317) 421-2012

2451 Intelliplex Dr
#210
Shelbyville, IN 46176
Phone (317) 421-1914

30 W Rampart St
Ste 200
Shelbyville, IN 46176
Phone (317) 398-0121

30 W Rampart St
Ste 250
Shelbyville, IN 46176
Phone (317) 398-7337

2451 Intelliplex Dr
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 3

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1194701359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 FOXBOROUGH RUN",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461762879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FOXBOROUGH RUN",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "46176",
            "telephone_number": "317-512-2711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8177 Clearvista Pkwy",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462561662",
            "country_code": "US",
            "telephone_number": "317-621-7801",
            "fax_number": "317-621-7205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPRINGER",
        "first_name": "JAMES",
        "middle_name": "LEROY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD17476",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01065737A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032073",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBMC GROUP NPI NUMBER",
            "identifier": "1407812365",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN NUMBER",
            "identifier": "P00143357",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN NUMBER",
            "identifier": "R0000WFBTV",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201195760",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP NUMBER",
            "identifier": "CB3544",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PTAN",
            "identifier": "P01307618",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

Verify at the official NPI Registry.