Individual provider Active NPI

James J Im, MD

  • Family Medicine Physician
  • Bakersfield, CA
National Provider Identifier
1386732253
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00A604310 Issued in CA
Practice address
2731 H St Ste B
Bakersfield, CA 93301-1952
Phone
(661) 664-8484
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 00A604310 CA Primary

Addresses

Primary practice location

2731 H St Ste B
Bakersfield, CA 93301-1952

Mailing address

2731 H St Ste B
Bakersfield, CA 93301-1952
Phone (661) 664-8484

Other identifiers 1

IdentifierTypeStateIssuer
00A604310MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050826000595 CA Practitioner - Family Practice 0547291791 Practice locations: Bakersfield, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00A604310CAMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1386732253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2731 H ST STE B",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933011952",
            "telephone_number": "661-664-8484",
            "fax_number": "661-663-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2731 H ST STE B",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933011952",
            "telephone_number": "661-664-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IM",
        "first_name": "JAMES",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "00A604310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A604310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.