Active NPI
Walter Ennis James III, MD
- Cardiovascular Disease Physician
- Greenwood, SC
National Provider Identifier
1851383590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- SC9239
- Practice address
- 421 Epting Ave
Greenwood, SC 29646-4041 - Phone
- (864) 227-6818
- Fax
- (864) 227-0850
- NPI assigned
- Aug 18, 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | SC9239 | SC | Primary |
Addresses
Primary practice location
421 Epting Ave
Greenwood, SC 29646-4041
Mailing address
421 Epting Ave
Greenwood, SC 29646-4041
Phone (864) 227-6818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 092394 | Medicaid | SC |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC9239 | SC | MD | Cardiovascular Disease Physician |
| 9239 | SC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Self Medical Group | Past | Accepting new patients | |
| Self Regional Healthcare | Past | Accepting new patients |
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359504000000",
"number": "1851383590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "421 EPTING AVE",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296464041",
"telephone_number": "864-227-6818",
"fax_number": "864-227-0850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 EPTING AVE",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296464041",
"telephone_number": "864-227-6818",
"fax_number": "864-227-0850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMES",
"first_name": "WALTER",
"middle_name": "ENNIS",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-18",
"last_updated": "2013-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "SC",
"license": "SC9239",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "092394",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.