NPIMap

Individual provider Active NPI

James M Detherage, MD

  • Family Medicine Physician
  • Ashland, KY
National Provider Identifier
1881608867
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35730 Issued in KY
Practice address
617 23Rd St Ste 212
Ashland, KY 41101-2880
Phone
(606) 408-8485
Fax
(606) 408-1351
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35082207 OH
Family Medicine Physician 207Q00000X 35730 KY Primary

Addresses

Primary practice location

617 23Rd St Ste 212
Ashland, KY 41101-2880

Mailing address

PO Box 2379
Ashland, KY 41105-2379
Phone (606) 408-6200

Other identifiers 4

IdentifierTypeStateIssuer
080180308OtherKYRR MEDICARE
2282462MedicaidOH
P00852998OtherKYRR MEDICARE
64012669MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdetherage9303@direct.kdhealth.us Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20070702000529 KY Practitioner - Family Practice 3274535927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashland Hospital CorporationGroup PAC ID 7719882521, 169 clinicians
Premier Therapy and Health Centers IncGroup PAC ID 7416859574, shared by 6 NPIs, 263 clinicians

Practice addresses (Care Compare)

1107 Bellefonte Rd
Flatwoods, KY 41139-2503
Phone (606) 834-0125

2400 13TH St
Ashland, KY 41102-4510
Phone (606) 329-0910

617 23Rd St
Suite 215
Ashland, KY 41101-2870
Phone (606) 408-1260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.04 of 100Reported as group
Quality
60.55
Promoting interoperability
100
Improvement activities
40
Cost
78.81

Merit-based Incentive Payment System (MIPS)

Final score
89.16 of 100Reported as group
Quality
77.42
Promoting interoperability
100
Improvement activities
40
Cost
77.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35082207OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Daughters Medical Specialties Inc CurrentSince Jul 4, 2010 Accepting new patients
Ashland Hospital Corporation Family Medicine CurrentSince Jan 1, 2008 Accepting new patients
Kings Daughters Medical Specialties Inc Current Accepting new patients
Kings Daughters Medical Specialties Interventional Spine CurrentSince Jul 4, 2010 Accepting new patients
Ashland Hospital Corporation Current Accepting new patients
Ashland Hospital Corporation Family Medicine CurrentSince Jan 1, 2008 Accepting new patients
Ashland Hospital Corporation Family Medicine Past Accepting new patients
Wurtland Nursing and Rehabilitation LLC Past Accepting new patients

Locations

10650 US Route 60
Ashland, KY 41102
Phone (606) 408-6301

617 23rd St
Ste 212
Ashland, KY 41101
Phone (606) 408-8485

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

12100 Princeland Spur
Ashland, KY 41102
Phone (606) 928-2963

617 23rd St
Ste 215
Ashland, KY 41101
Phone (606) 408-1260

1107 Bellefonte Rd
Flatwoods, KY 41139
Phone (606) 834-0125

105A State Highway 1947
Grayson, KY 41143
Phone (606) 474-7892

100 Wurtland Ave
Wurtland, KY 41144
Phone (606) 834-0144

384 County Road 120 S
South Point, OH 45680
Phone (740) 894-2080

Interoperability endpoints

  • Direct secure messaging: mdetherage9303@direct.kdhealth.us

Organizations & group practices 8

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.

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1881608867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 23RD ST STE 212",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012880",
            "telephone_number": "606-408-8485",
            "fax_number": "606-408-1351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETHERAGE",
        "first_name": "JAMES",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35082207",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "35730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080180308",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2282462",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00852998",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64012669",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdetherage9303@direct.kdhealth.us",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "txt",
            "address_1": "617 23rd St Ste 212",
            "city": "Ashland",
            "state": "KY",
            "country_code": "US",
            "postal_code": "411012880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.