James Read Blaine, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R7631 Issued in MO

Practice address

815 N Sherman Ave
Suite 208
Springfield, MO 65802-3757

Phone

(417) 866-3133

Fax

(417) 866-3233

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Citizens Memorial Healthcare

  • Surgery Physician
  • Bolivar, MO
  • NPI 1568566131

  Family Medicine

  NPD (past)
• Citizens Memorial Healthcare Clinics

  • Durable Medical Equipment & Medical Supplies
  • Bolivar, MO
  • NPI 1972769404
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1386737526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 E CRYSTAL HILL LANE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65803",
            "telephone_number": "417-833-3831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N SHERMAN AVE",
            "address_2": "SUITE 208",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658023757",
            "telephone_number": "417-866-3133",
            "fax_number": "417-866-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAINE",
        "first_name": "JAMES",
        "middle_name": "READ",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R7631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200482032",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Misty Dawn Blackmon, RN
• Robert H Blackshear, MD
• Ross McCord Blackshear, MD
• Steven Blackshear, DO
• Magen Morine Blades, P.A.
• Amy Anh-Thu Blair, PHARM D
• Megan Blake, M.S., CCC-SLP
• Shelly Jean Blanchard, MA, LMFT
• Cameron Joseph Bland, PT
• Addie A Blankenship, MSW, LCSW

• Family Medicine Physician in Springfield, MO
• Providers in Springfield, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.