James R Debord, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036052063 Issued in IL

Practice address

1001 Main Street
3Rd Floor
Peoria, IL 61606-2037

Phone

(309) 495-0200

Fax

(309) 676-6545

NPI assigned

Jun 23, 2006

Last updated

Oct 25, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Associated University Neurosurgeons SC

  • Neurological Surgery Physician
  • Peoria, IL
  • NPI 1265487664
  NPD (past)
• Proctor Community Hospital

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1134826894
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1649206533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN STREET",
            "address_2": "3RD FLOOR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616062037",
            "telephone_number": "309-495-0200",
            "fax_number": "309-676-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN STREET",
            "address_2": "3RD FLOOR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616062037",
            "telephone_number": "309-495-0200",
            "fax_number": "309-676-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBORD",
        "first_name": "JAMES",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036052063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036052063-1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "7215166",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellyn Dearing, M.S., CFY-SLP
• Jenelle Deatherage, PT
• Elizabeth Debernardi, PT
• Deborah Simonis LCSW
• Alan Debord, MD
• Anthony V Deceanne, DPM
• Arleta Dedianous, APRN
• Fizza Deen, MD
• Erica M Deford, PA
• Jason Deford, LCPC

• Surgery Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.