Individual provider Active NPI

Johnnie Eugene James, MS, LAT, ATC

  • Athletic Trainer
  • Davenport, IA
National Provider Identifier
1538218649
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
00622 Issued in IA
Practice address
518 W Locust St
Davenport, IA 52803-2829
Phone
(563) 333-6062
Fax
(563) 333-6239
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 00622 IA Primary

Addresses

Primary practice location

518 W Locust St
Davenport, IA 52803-2829

Mailing address

3820 Belle Ave
Davenport, IA 52807-1181
Phone (563) 359-3012

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
00622IAMDClinical Child & Adolescent Psychologist

Interoperability endpoints

  • Direct secure messaging: jjames58881@uihcdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538218649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 BELLE AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071181",
            "telephone_number": "563-359-3012",
            "fax_number": "563-333-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 W LOCUST ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032829",
            "telephone_number": "563-333-6062",
            "fax_number": "563-333-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "JOHNNIE",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "00622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.