Individual provider Active NPI

James Stephen Nobles, P.A.

  • Physician Assistant
  • Douglas, GA
National Provider Identifier
1831302868
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
003463 Issued in GA
Practice address
1380 Gordon St W
Douglas, GA 31533-3432
Phone
(912) 384-3204
Fax
(912) 384-9346
NPI assigned
May 7, 2007
Last updated
Mar 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 003463 GA Primary
Surgical Physician Assistant 363AS0400X 003463 GA
Medical Physician Assistant 363AM0700X 003463 GA

Addresses

Primary practice location

1380 Gordon St W
Douglas, GA 31533-3432

Mailing address

2400 Bellevue Rd
Suite 21-a
Dublin, GA 31021-2885
Phone (478) 275-7202

Other identifiers 2

IdentifierTypeStateIssuer
003463OtherGAGEORGIA LICENSE
003113320MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041110000025 GA Practitioner - Physician Assistant 1355304452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical College of Georgia School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Dermatology and Skin Cancer Center, LLCGroup PAC ID 7113980855, 53 clinicians

Practice addresses (Care Compare)

1157 Forsyth St
Macon, GA 31201-7452
Phone (478) 745-8581

408 E 4TH Ave
Cordele, GA 31015-3619
Phone (229) 276-1122

631 E Forsyth St
Americus, GA 31709-3716
Phone (229) 924-6006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003463GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Dermatology &Skin Cancer Center, PC Past Accepting new patients
Dermatology & Skin Cancer Center Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1831302868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 BELLEVUE RD",
            "address_2": "SUITE 21-A",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212885",
            "telephone_number": "478-275-7202",
            "fax_number": "478-274-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 GORDON ST W",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333432",
            "telephone_number": "912-384-3204",
            "fax_number": "912-384-9346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLES",
        "first_name": "JAMES",
        "middle_name": "STEPHEN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "003463",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "003463",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003463",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA LICENSE",
            "identifier": "003463",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003113320",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

Verify at the official NPI Registry.