Individual provider Active NPI

James Marvin Staples, ARNP

  • Family Nurse Practitioner
  • Auburn, KY
National Provider Identifier
1386751709
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3226P Issued in KY
Practice address
104 E Main St
Auburn, KY 42206-5106
Phone
(270) 542-8888
Fax
(270) 542-7335
NPI assigned
Aug 23, 2006
Last updated
Jan 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3226P KY Primary

Addresses

Primary practice location

104 E Main St
Auburn, KY 42206-5106

Mailing address

PO Box 66
Auburn, KY 42206-0066
Phone (270) 542-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090619000165 KY Practitioner - Nurse Practitioner 7618028333 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Staples Health Clinic LLCGroup PAC ID 6406152925, 3 clinicians

Practice addresses (Care Compare)

104 E Main St
Auburn, KY 42206-5106
Phone (270) 542-8888

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Logan Physician Practice LLC CurrentSince Apr 12, 2011 Accepting new patients
Logan Physician Practice, LLC CurrentSince Apr 12, 2011 Accepting new patients
Staples Health Clinic, LLC Family CurrentSince Feb 1, 2016 Accepting new patients
Southern Kentucky Heart Institute,PSC PastSince Feb 1, 2016 Accepting new patients
J. Todd Douglas, MD, PSC Family Past Accepting new patients
Commonwealth Health Corp, Inc. Family Past Accepting new patients

Locations

128 Sugar Maple Dr
Auburn, KY 42206
Phone (270) 344-5157

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1386751709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66",
            "city": "AUBURN",
            "state": "KY",
            "postal_code": "422060066",
            "telephone_number": "270-542-8888",
            "fax_number": "270-542-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E MAIN ST",
            "city": "AUBURN",
            "state": "KY",
            "postal_code": "422065106",
            "telephone_number": "270-542-8888",
            "fax_number": "270-542-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "JAMES",
        "middle_name": "MARVIN",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3226P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, KY

Sources for this page

Verify at the official NPI Registry.