James R. Kisselburg, M,D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

76594 Issued in GA

Practice address

1900 Tebeau Street
Waycross, GA 31501

Phone

(912) 338-6438

Fax

(912) 338-6439

NPI assigned

Apr 29, 2009

Last updated

Aug 19, 2016By the provider in NPPES

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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Group practices

Southland Emergency Medical Services Consolidated, LLCGroup PAC ID 4183871320, 48 clinicians

Southland Cochran Emergency Medical Services LLCGroup PAC ID 9638398027, 17 clinicians

Southland Bainbridge Hospitalist Group, LLCGroup PAC ID 7214248335, 54 clinicians

Southland Optim Jenkins Emergency Medical Services, LLCGroup PAC ID 9537461538, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Liberty Regional Medical Center Hospital, Hinesville, GA, CCN 111335
• Bleckley Memorial Hospital Hospital, Cochran, GA, CCN 111302
• Bleckley Memorial Hospital Nursing home, CCN 11Z302

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southland Bainbridge Hospitalist Group, LLC

  • Hospitalist Physician
  • Bainbridge, GA
  • NPI 1356735336
  Medicare reassignment Care Compare group NPD
• Southland Cochran Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Cocharan, GA
  • NPI 1205241395
  Medicare reassignment Care Compare group NPD
• Southland Emergency Medical Services Consolidated, LLC

  • Hospitalist Physician
  • Cochran, GA
  • NPI 1033464391
  Medicare reassignment Care Compare group NPD
• Southland Optim Jenkins Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Millen, GA
  • NPI 1265826242
  Medicare reassignment Care Compare group
• Mayo Clinic Health System in Waycross, Inc.

  • Multi-Specialty Clinic/Center
  • Waycross, GA
  • NPI 1154745982
  Medicare reassignment NPD
• Southland Burke Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Waynesboro, GA
  • NPI 1235885815
  Medicare reassignment NPD
• Southland Consolidated Emergency Services, LLC

  • Emergency Medicine Physician
  • Elberton, GA
  • NPI 1174917124
  Medicare reassignment NPD
• Southland Dodge Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Eastman, GA
  • NPI 1851958607
  Medicare reassignment
• Hospital Authority of Candler County

  dba Pulaski Health & Wellness

  • Primary Care Clinic/Center
  • Pulaski, GA
  • NPI 1316523707
  NPD
• Hospital Authority of Candler County

  dba Candler County Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Metter, GA
  • NPI 1588868947
  NPD
• Hospital Authority of Candler County

  dba Candler County Hospital

  • Critical Access Hospital
  • Metter, GA
  • NPI 1790888089
  NPD
• Mayo Clinic Health System in Waycross, Inc.

  • Rehabilitation Hospital Unit
  • Waycross, GA
  • NPI 1548322084
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bleckley County Hospital

  dba Bleckley Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Cochran, GA
  • NPI 1053461376

  Nursing home

  Care Compare affiliation
• Bleckley County Hospital

  dba Bleckley Memorial Hospital

  • Critical Access Hospital
  • Cochran, GA
  • NPI 1578637526
  Care Compare affiliation
• Hospital Authority of Liberty County

  dba Liberty Regional Medical Center

  • Critical Access Hospital
  • Hinesville, GA
  • NPI 1326079260
  Care Compare affiliation

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1841434255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 TEBEAU STREET",
            "address_2": "MAYO CLINIC HEALTH SYSTEM",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "31501",
            "telephone_number": "912-338-6438",
            "fax_number": "912-338-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 TEBEAU STREET",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "31501",
            "telephone_number": "912-338-6438",
            "fax_number": "912-338-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSELBURG",
        "first_name": "JAMES",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M,D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-29",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "76594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emilie Ann King, FNP-C
• Donna Kirby, RN
• Jana Kirby, L.M.T
• Kristian Edward Kirkland, RN
• Linda Kirkland
• Charles W. Klein III, PA-C
• Cheryl A Klug, F.N.P. C
• Gerardo Alberto Klug, M.D.
• Sara S Knox, FNP-C
• Marsha Kriete, LPN

• Hospitalist Physician in Waycross, GA
• Providers in Waycross, GA by specialty
• Hospitalist Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.