Active NPI
James Daniel Kubley, MD
- Family Medicine Physician
- Supply, NC
National Provider Identifier
1205808136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 9801344
- Practice address
- 1 Medical Center Dr
Supply, NC 28462-3350 - Phone
- (910) 755-1004
- Fax
- (910) 755-1474
- NPI assigned
- Feb 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9801344 | NC | Primary |
Addresses
Primary practice location
1 Medical Center Dr
Supply, NC 28462-3350
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (910) 755-1004
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891157M | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9801344 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roanoke Valley Health Services Inc | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Henrico, NC
- NPI 1881704997
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279497600000",
"number": "1205808136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447",
"telephone_number": "910-755-1004",
"fax_number": "910-755-1474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "SUPPLY",
"state": "NC",
"postal_code": "284623350",
"telephone_number": "910-755-1004",
"fax_number": "910-755-1474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUBLEY",
"first_name": "JAMES",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-04",
"last_updated": "2010-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "9801344",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891157M",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Supply, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.