Provider Demographics
NPI:1497750178
Name:ADAMS, JAMES (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936857
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-6857
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1333 S DICKINSON DR UNIT 230
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-6434
Practice Address - Country:US
Practice Address - Phone:910-662-6600
Practice Address - Fax:910-332-0246
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9801132207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC2717OtherMEDCOST
NC1322HOtherBCBS
NC1497750178Medicaid
NC080195163OtherRAILROAD MEDICARE
NC080194316OtherRAILROAD MEDICARE
SC205923Medicaid
NC891322HMedicaid
NC01-030506OtherUNITED HEALTHCARE
NC1497750178Medicaid
NCNCM040BMedicare PIN
NCNCM040AMedicare PIN
NC080195163OtherRAILROAD MEDICARE
NC2263829BMedicare PIN
NC2263829CMedicare PIN