Active NPI
James R Byrn, MD
- Pediatrics Physician
- Muncie, IN
National Provider Identifier
1235110503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01024076
- Practice address
- 205 N Tillotson Ave
Muncie, IN 47304-3900 - Phone
- (765) 288-1995
- Fax
- (765) 281-9114
- NPI assigned
- Nov 14, 2005
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01024076 | IN | Primary |
Addresses
Primary practice location
205 N Tillotson Ave
Muncie, IN 47304-3900
Mailing address
205 N Tillotson Ave
Muncie, IN 47304-3900
Phone (765) 288-1995
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100105150 | Medicaid | IN | |
| 01024076A | Other | IN | PHYSICIAN LICENSURE |
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 |
|---|---|---|---|
| 01024076 | IN | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308268800000",
"number": "1235110503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 N TILLOTSON AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473043900",
"telephone_number": "765-288-1995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 N TILLOTSON AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473043900",
"telephone_number": "765-288-1995",
"fax_number": "765-281-9114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYRN",
"first_name": "JAMES",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-14",
"last_updated": "2011-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01024076",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100105150",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIAN LICENSURE",
"identifier": "01024076A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.