Active NPI
James Allen Adams, O.D.
- Optometrist
- Portage, MI
National Provider Identifier
1336137397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901002440
- Practice address
- 6101 Newport Rd
Suite a
Portage, MI 49002-9233 - Phone
- (269) 382-6500
- Fax
- (269) 382-2286
- NPI assigned
- Oct 12, 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901002440 | MI | Primary |
Addresses
Primary practice location
6101 Newport Rd
Suite a
Portage, MI 49002-9233
Mailing address
6101 Newport Rd
Suite a
Portage, MI 49002-9233
Phone (269) 382-6500
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 381734365 | Other | MI | TAX ID |
| 17800 | Other | MI | SPECTERA |
| 900C947460 | Other | MI | BCBS |
| 5031190 | Medicaid | MI | |
| 4901002440 | Other | MI | LICENSE |
| 2230411 | Other | MI | UHC,IBA,PHP |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901002440 | MI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271116800000",
"number": "1336137397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6101 NEWPORT RD",
"address_2": "SUITE A",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490029233",
"telephone_number": "269-382-6500",
"fax_number": "269-382-2286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6101 NEWPORT RD",
"address_2": "SUITE A",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490029233",
"telephone_number": "269-382-6500",
"fax_number": "269-382-2286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS",
"first_name": "JAMES",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-12",
"last_updated": "2010-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901002440",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "381734365",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA",
"identifier": "17800",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "900C947460",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5031190",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "4901002440",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC,IBA,PHP",
"identifier": "2230411",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portage, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.