Individual provider Active NPI

James Russell Macswords III, PA-C

  • Physician Assistant
  • Georgetown, KY
National Provider Identifier
1194778712
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA040 Issued in KY
Practice address
111 Osbourne Way
Ste 101
Georgetown, KY 40324-8004
Phone
(859) 570-0007
Fax
(859) 570-0500
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA040 KY Primary

Addresses

Primary practice location

111 Osbourne Way
Ste 101
Georgetown, KY 40324-8004

Mailing address

111 Osbourne Way
Ste 101
Georgetown, KY 40324-8004
Phone (859) 570-0007

Other identifiers 1

IdentifierTypeStateIssuer
95000402MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081216000046 KY Practitioner - Physician Assistant 4486716065 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA040KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Lexington Urgent Treatment Associates, PSC Past Accepting new patients
Kentucky Medical Services Foundation, Inc Past Accepting new patients
Marshall Emergency Services Associates, PLLC Physician Assistant Past Accepting new patients

Organizations & group practices 9

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1194778712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OSBOURNE WAY",
            "address_2": "STE 101",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248004",
            "telephone_number": "859-570-0007",
            "fax_number": "859-570-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OSBOURNE WAY",
            "address_2": "STE 101",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248004",
            "telephone_number": "859-570-0007",
            "fax_number": "859-570-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACSWORDS",
        "first_name": "JAMES",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95000402",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

Verify at the official NPI Registry.