Active NPI
James R Northern, DO
- Diagnostic Radiology Physician
- Mexico, MO
National Provider Identifier
1801885702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- R8A00
- Practice address
- 620 E Monroe St
Mexico, MO 65265-2919 - Phone
- (573) 581-5850
- Fax
- (573) 581-8185
- NPI assigned
- Oct 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | R8A00 | MO | Primary |
Addresses
Primary practice location
620 E Monroe St
Mexico, MO 65265-2919
Mailing address
201 E Monroe St
Suite 202
Mexico, MO 65265-2852
Phone (573) 581-5850
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 243605805 | Medicaid | MO | |
| 300044909 | Other | MO | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R8A00 | MO | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Imaging Associates of Mexico Mo | Diagnostic Radiology | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Mexico, MO
- NPI 1487659140
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279756800000",
"number": "1801885702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 E MONROE ST",
"address_2": "SUITE 202",
"city": "MEXICO",
"state": "MO",
"postal_code": "652652852",
"telephone_number": "573-581-5850",
"fax_number": "573-581-8185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 E MONROE ST",
"city": "MEXICO",
"state": "MO",
"postal_code": "652652919",
"telephone_number": "573-581-5850",
"fax_number": "573-581-8185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORTHERN",
"first_name": "JAMES",
"middle_name": "R",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-14",
"last_updated": "2010-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "R8A00",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "243605805",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "300044909",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mexico, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.