James W Phoenix, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036059274 Issued in IL

Practice address

1747 Henry Luckow LN
Belvidere, IL 61008-1702

Phone

(815) 971-3030

Fax

(815) 971-9895

NPI assigned

Jan 30, 2007

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

Locations

Interoperability endpoints

• Direct secure messaging: ms_jphoeni4@landmarkhealth-direct.org

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.

• Rockford Health Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment NPD
• RMH Pathologists, LTD

  • Anatomic Pathology Physician
  • Rockford, IL
  • NPI 1184671992
  NPD

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1700922267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 HENRY LUCKOW LN",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081702",
            "telephone_number": "815-971-3030",
            "fax_number": "815-971-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 HENRY LUCKOW LN",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081702",
            "telephone_number": "815-971-3030",
            "fax_number": "815-971-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOENIX",
        "first_name": "JAMES",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036059274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F400205679",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036059274",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy A Palmer, APRN
• Christopher Michael Parrett, D.C.
• William Pawlak, O. D.
• Elizabeth Perez, RPH
• Joshua Perez
• Cassie M Piske, LMT RYT
• Jessica Piske, LCSW
• David G Pocock, M.D.
• Shelli Pollard, LCSW
• Roger Allen Pope, DC

• Family Medicine Physician in Belvidere, IL
• Providers in Belvidere, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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.