NPIMap

Individual provider Active NPI

James Harrison Raybourn III, M.D.

  • Urology Physician
  • Greenwood, IN
National Provider Identifier
1871736595
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
01073813A Issued in IN
Practice address
679 E County Line Rd
Greenwood, IN 46143-1049
Phone
(317) 859-7222
NPI assigned
Apr 10, 2009
Last updated
Jan 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Urology Physician 208800000X 01073813A IN Primary

Addresses

Primary practice location

679 E County Line Rd
Greenwood, IN 46143-1049

Mailing address

679 E County Line Rd
Greenwood, IN 46143-1049
Phone (317) 807-1262

Other identifiers 4

IdentifierTypeStateIssuer
1487680518OtherINGROUP NPI
000000876695OtherINANTHEM
100194370OtherINMEDICAID GROUP NUMBER
201227520MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address urologyin@directaddress.net Urology of Indiana L.L.C.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140623001877 IN Practitioner - Urology 2264656867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Indiana University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology of Indiana LLCGroup PAC ID 7517870009, 79 clinicians

Practice addresses (Care Compare)

679 E County Line Rd
Greenwood, IN 46143-1049
Phone (317) 859-7222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection21
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Urology of Indiana L.L.C. Urology CurrentSince Aug 1, 2014 Accepting new patients
Urology of Indiana, L.L.C. CurrentSince Aug 1, 2014 Accepting new patients
Urology of Indiana L.L.C. Past Accepting new patients
Urology of Indiana L.L.C. Past Accepting new patients
Major Hospital Past Accepting new patients
Urology of Indiana, L.L.C. Urology Past Accepting new patients
Urology of Indiana L.L.C. Past Accepting new patients
Urology of Indiana, LLC Past Accepting new patients
Urology of Indiana L.L.C. Past Accepting new patients
Urology of Indiana L.L.C. Past Accepting new patients
Urology of Indiana, L.L.C. Past Accepting new patients
Urology of Indiana, L.L.C. Past Accepting new patients
Urology of Indiana L.L. C. Past Accepting new patients
Urology of Indiana L.L.C. Past Accepting new patients
Urology of Indiana L.L.C Past Accepting new patients
Urology of Indiana L.L.C. Past Accepting new patients
Urology of Indiana, L.L.C. Past Accepting new patients
Urology of Indiana L.L.C. Past Accepting new patients
Urology of Indiana, L.L.C. Past Accepting new patients

Locations

2907 S McIntire Dr
Ste A
Bloomington, IN 47403
Phone (812) 332-8765

14300 E 138th
Ste A
Fishers, IN 46037
Phone (317) 813-1660

679 E County Line Rd
Greenwood, IN 46143
Phone (317) 807-1262

1270 N Post Rd
Ste A
Indianapolis, IN 46219
Phone (317) 895-6095

1215 Hadley Rd
#203
Mooresville, IN 46158
Phone (317) 831-3043

1215 Hadley Rd
Ste 203
Mooresville, IN 46158
Phone (317) 831-3043

Interoperability endpoints

  • Direct secure messaging: jraybourn179589@direct.franciscanalliance.org
  • Direct secure messaging: urologyin@directaddress.net

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1871736595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 E COUNTY LINE RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431049",
            "telephone_number": "317-807-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 E COUNTY LINE RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431049",
            "telephone_number": "317-859-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBOURN",
        "first_name": "JAMES",
        "middle_name": "HARRISON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-10",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01073813A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1487680518",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000876695",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NUMBER",
            "identifier": "100194370",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201227520",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "urologyin@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Urology of Indiana L.L.C.",
            "address_1": "679 E County Line Rd",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461431049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.