Individual provider Active NPI

Deborah Jackson James

  • Nurse Practitioner
  • King, NC
National Provider Identifier
1881995371
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5004857 Issued in NC
Practice address
167 Moore Rd Ste 206
King, NC 27021-8770
Phone
(336) 673-6450
Fax
(336) 673-6449
NPI assigned
Nov 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5004857 NC
Nurse Practitioner 363L00000X 5004857 NC Primary

Addresses

Primary practice location

167 Moore Rd Ste 206
King, NC 27021-8770

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

167 Moore Rd Ste 201
King, NC 27021
Phone (336) 673-6450

Other practice location 2

216 Moore Rd
King, NC 27021-8703
Phone (336) 983-4346

Other practice location 3

2337 Winterhaven Ln
Winston Salem, NC 27103-6792
Phone (336) 774-0044

Other practice location 4

7811 N Point Blvd
Winston Salem, NC 27106-3209
Phone (336) 759-0700

Other identifiers 1

IdentifierTypeStateIssuer
7005753MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address djames4628@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20110208000805 NC Practitioner - Nurse Practitioner 5193905180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1122 Randolph St
Suite 110
Thomasville, NC 27360-5730
Phone (336) 474-3433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5004857NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 20, 2019 Accepting new patients
Forsyth Memorial Hospital Inc CurrentSince Oct 29, 2017 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Oct 29, 2017 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Forsyth Memorial Hospital, Inc Past Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

216 Moore Rd
King, NC 27021
Phone (336) 768-1270

865 Westlake Dr
Mount Airy, NC 27030
Phone (336) 719-6100

207 Medical St
Pilot Mountain, NC 27041
Phone (336) 368-5011

1122 Randolph St
Ste 110
Thomasville, NC 27360
Phone (336) 474-3433

100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Interoperability endpoints

  • Direct secure messaging: djames4628@direct.novanthealth.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1881995371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 MOORE RD STE 206",
            "city": "KING",
            "state": "NC",
            "postal_code": "270218770",
            "telephone_number": "336-673-6450",
            "fax_number": "336-673-6449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "167 Moore Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "King",
            "state": "NC",
            "postal_code": "27021",
            "country_code": "US",
            "telephone_number": "336-673-6450",
            "fax_number": "336-673-6449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 Moore Rd",
            "address_purpose": "LOCATION",
            "city": "King",
            "state": "NC",
            "postal_code": "270218703",
            "country_code": "US",
            "telephone_number": "336-983-4346",
            "fax_number": "336-985-5101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2337 Winterhaven Ln",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036792",
            "country_code": "US",
            "telephone_number": "336-774-0044",
            "fax_number": "336-277-4349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7811 N Point Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271063209",
            "country_code": "US",
            "telephone_number": "336-759-0700",
            "fax_number": "336-759-2226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMES",
        "first_name": "DEBORAH",
        "middle_name": "JACKSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004857",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005753",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "djames4628@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "7811 N Point Blvd",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271063209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in King, NC

Sources for this page

Verify at the official NPI Registry.