Individual provider Active NPI

James F Mracek, MD

  • Internal Medicine Physician
  • Wetumpka, AL
National Provider Identifier
1588720452
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00018329 Issued in AL
Practice address
807 Jackson Trace Rd
Wetumpka, AL 36092-1504
Phone
(334) 567-3150
Fax
(334) 567-3152
NPI assigned
Dec 28, 2006
Last updated
Oct 31, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 00018329 AL Primary

Addresses

Primary practice location

807 Jackson Trace Rd
Wetumpka, AL 36092-1504

Mailing address

807 Jackson Trace Rd
Wetumpka, AL 36092-1504
Phone (334) 567-3150

Other identifiers 1

IdentifierTypeStateIssuer
000033706MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20031209000181 AL Practitioner - Internal MedicinePractitioner - General PracticePractitioner - Family PracticePractitioner - Hospice/Palliative Care 1951207257

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00018329ALMDInternal Medicine Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1588720452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 JACKSON TRACE RD",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360921504",
            "telephone_number": "334-567-3150",
            "fax_number": "334-567-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 JACKSON TRACE RD",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360921504",
            "telephone_number": "334-567-3150",
            "fax_number": "334-567-3152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MRACEK",
        "first_name": "JAMES",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00018329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000033706",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wetumpka, AL

Sources for this page

Verify at the official NPI Registry.