Provider Demographics
NPI:1518986363
Name:ROSS, JAMES (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:ROSS
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 1:3725 KINGFISHER LN
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:NC
Mailing Address - Zip Code:28682-9759
Mailing Address - Country:US
Mailing Address - Phone:828-326-3809
Mailing Address - Fax:
Practice Address - Street 1:2890 S LOOKOUT ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NC
Practice Address - Zip Code:28610-9528
Practice Address - Country:US
Practice Address - Phone:828-326-3809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14526207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC73305OtherBCBS - CLAREMONT
NC8973305Medicaid
NC8973305Medicaid
NCC89453Medicare UPIN
NC8973305Medicaid