Active NPI
James Edward Myers, PSY.D.
- Clinical Psychologist
- Springfield, IL
National Provider Identifier
1912006099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071-005601
- Practice address
- 1 W Old State Capitol PLZ
Suite 521
Springfield, IL 62701-1200 - Phone
- (217) 523-3955
- Fax
- (217) 523-5514
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071-005601 | IL | Primary |
Addresses
Primary practice location
1 W Old State Capitol PLZ
Suite 521
Springfield, IL 62701-1200
Mailing address
PO Box 5403
Springfield, IL 62705-5403
Phone (217) 523-3955
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BC/BS | Other | IL | 8432038 |
| MAGELLAN | Other | IL | 272012000 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060418000072 | IL | Practitioner - Clinical Psychologist | 6305855529 | Practice locations: Springfield, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1 W Old State Capitol Plaza
Suite 521
Springfield, IL 62701-1200
Phone (217) 523-3955
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388016000000",
"number": "1912006099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5403",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627055403",
"telephone_number": "217-523-3955",
"fax_number": "217-523-5514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 W OLD STATE CAPITOL PLZ",
"address_2": "SUITE 521",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627011200",
"telephone_number": "217-523-3955",
"fax_number": "217-523-5514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "JAMES",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2013-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071-005601",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "8432038",
"identifier": "BC/BS",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "272012000",
"identifier": "MAGELLAN",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; 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.