Individual provider Active NPI

James Bruce Destephens, M.D.

  • Cardiovascular Disease Physician
  • Gainesville, FL
National Provider Identifier
1982684460
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME0045204 Issued in FL
Practice address
2341 NW 41St St
Suite B
Gainesville, FL 32606-7494
Phone
(352) 371-1804
Fax
(352) 371-2033
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME0045204 FL Primary

Addresses

Primary practice location

2341 NW 41St St
Suite B
Gainesville, FL 32606-7494

Mailing address

2341 NW 41St St
Suite B
Gainesville, FL 32606-7494
Phone (352) 371-1804

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100927000104 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7719003888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Medical College of Ohio, 1980
Medicare assignment
May accept Medicare assignment
Group practices
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

2341 NW 41St St
Suite B
Gainesville, FL 32606-7442
Phone (352) 371-1804

PO Box
Suite 1099
Melrose, FL 32666-1099

Hospital & facility affiliations

  • HCA Florida North Florida Hospital Hospital, Gainesville, FL, CCN 100204

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0045204FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
James B Destephens MD PA Cardiovascular Disease CurrentSince Apr 15, 2002 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2341 NW 41st St
Ste B
Gainesville, FL 32606
Phone (352) 371-1804

Interoperability endpoints

  • Direct secure messaging: james.destephens@djbd-fl.direct.office.nextgen.com

Organizations & group practices 3

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 1

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1982684460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2341 NW 41ST ST",
            "address_2": "SUITE B",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326067494",
            "telephone_number": "352-371-1804",
            "fax_number": "352-371-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 NW 41ST ST",
            "address_2": "SUITE B",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326067494",
            "telephone_number": "352-371-1804",
            "fax_number": "352-371-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTEPHENS",
        "first_name": "JAMES",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME0045204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.