Individual provider Active NPI

James Edward Fambro, MD

  • Emergency Medicine Physician
  • Slidell, LA
National Provider Identifier
1669410171
Registry record updated May 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
13751R Issued in LA
Practice address
985 Robert Blvd
Suite 101
Slidell, LA 70458-2063
Phone
(985) 690-8300
Fax
(985) 690-8301
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 13751R LA Primary

Addresses

Primary practice location

985 Robert Blvd
Suite 101
Slidell, LA 70458-2063

Mailing address

985 Robert Blvd
Suite 101
Slidell, LA 70458-2063
Phone (985) 690-8300

Other identifiers 1

IdentifierTypeStateIssuer
1434591MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110520000449 TX Practitioner - Emergency MedicinePractitioner - Family Practice 4789659830 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Urgent Care, PA CurrentSince Aug 9, 2019 Accepting new patients
Nes Louisiana Inc Emergency Medicine Past Accepting new patients
Mid State Orthopaedic & Sports Medicine Center, LLC Past Accepting new patients
Mid State Orthopaedic & Sports Medicine Center LLC Past Accepting new patients
ER Medical Services, Inc. Emergency Medicine Past Accepting new patients
Acs Emergency Services of Mississippi Professional Association Emergency Medicine PastSince Sep 20, 2020 Accepting new patients
Ear, Nose, Throat Clinic of Slidell PastSince Feb 1, 2014 Accepting new patients
Lmchh PCP LLC Past Accepting new patients

Locations

330 S Denton Tap Rd
Coppell, TX 75019
Phone (469) 312-7777

9205 Legacy Dr
Frisco, TX 75033
Phone (972) 625-6020

2810 S Hardin Blvd
Ste 100
McKinney, TX 75072
Phone (972) 548-7277

8950 N Tarrant Pkwy
North Richlnd Hls, TX 76182
Phone (817) 281-7277

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398988800000",
    "number": "1669410171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 ROBERT BLVD",
            "address_2": "SUITE 101",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582063",
            "telephone_number": "985-690-8300",
            "fax_number": "985-690-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 ROBERT BLVD",
            "address_2": "SUITE 101",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582063",
            "telephone_number": "985-690-8300",
            "fax_number": "985-690-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMBRO",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2014-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "13751R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1434591",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.