Individual provider Active NPI

James Walter Girardy, M.D.

  • Surgery Physician
  • Rockford, IL
National Provider Identifier
1992738819
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Practice address
5668 E State St
Rockford, IL 61108-2490
Phone
(815) 397-7900
Fax
(815) 397-7919
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X IL Primary

Addresses

Primary practice location

5668 E State St
Rockford, IL 61108-2490

Mailing address

5668 E State St
Rockford, IL 61108-2490
Phone (815) 397-7900

Other identifiers 1

IdentifierTypeStateIssuer
30329600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036060433ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Surgical Service, S.C. Surgery Current Accepting new patients
St Mary Medical Center PastSince Sep 1, 1996 Accepting new patients
Mendota Community Hospital PastSince Apr 1, 2015 Accepting new patients
Saint Anthony Medical Center PastSince Sep 10, 2010 Accepting new patients
St Francis Hospital PastSince Mar 15, 1995 Accepting new patients
Osf Healthcare System PastSince Apr 12, 2007 Accepting new patients

Locations

5668 E State St
Ste 1000
Rockford, IL 61108
Phone (815) 229-7580

Organizations & group practices 6

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992738819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5668 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082490",
            "telephone_number": "815-397-7900",
            "fax_number": "815-397-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5668 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082490",
            "telephone_number": "815-397-7900",
            "fax_number": "815-397-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIRARDY",
        "first_name": "JAMES",
        "middle_name": "WALTER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30329600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.