James E Deboer, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036071275 Issued in ID

Practice address

311 W. Fairchild Street
Family Medicine/Convenient Care
Danville, IL 61832

Phone

(217) 431-7650

Fax

(217) 431-7634

NPI assigned

Jul 11, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1801821558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6002",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618036002",
            "telephone_number": "217-326-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W. FAIRCHILD STREET",
            "address_2": "FAMILY MEDICINE/CONVENIENT CARE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "61832",
            "telephone_number": "217-431-7650",
            "fax_number": "217-431-7634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOER",
        "first_name": "JAMES",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "036071275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6447860014",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Davis, PHARMD
• Clara Ann Davis
• Nadine Kathie Miyoko Day, M.P.T.
• Ronnie Lee Day, P.T.
• Johnna Deberry
• Jeffrey Brent Debord, PHD
• Jill Rhein Debord, MSW/LCSW
• Connie J Denmark, BS
• Dental Professionals of Illinois, P.C. (Danville Family Dental Care)
• Dental Professionals of Illinois, P.C. (North Vermillion Family Dental)

• Family Medicine Physician in Danville, IL
• Providers in Danville, 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 5, 2012; 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.