TERRY MATTHEW JAMES M.D.
NPI 1225250640
Family Medicine in Addison, AL

Q: What is Terry James's NPI number?

The NPI number for Terry James is 1225250640. It was assigned to this individual provider in the NPPES registry on May 3, 2007.

Q: What is Terry James's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Terry James was last updated on July 27, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 03, 2007PECOS Enrolled

14.94/100

CMS Quality Rating

16356 COUNTY ROAD 41, ADDISON, AL 35540(256) 747-1186(256) 747-1196 Get Directions Write a Review

NPPES record last updated: July 27, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Terry Matthew James M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TERRY MATTHEW JAMES M.D. (NPI 1225250640) is an individual family medicine provider in Addison, Alabama, licensed in Alabama (28387) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS and is a graduate of University Of Alabama School Of Medicine (2006).

NPPES Registry Identity

NPI1225250640

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameTERRY MATTHEW JAMESCredential: M.D.

Location Address16356 COUNTY ROAD 41Addison, AL 35540-2416

Mailing Address16356 County Road 41Addison, AL 35540-2416 · (256) 747-1186 · Fax (256) 747-1196

Phone(256) 747-1186

Fax(256) 747-1196

Sole ProprietorNo

Medical School CMSUniversity Of Alabama School Of MedicineGraduated 2006

Enumeration DateMay 3, 2007

Last NPPES UpdateJuly 27, 2015

✔ NPI 1225250640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in AL · 28387✔ Licensed in AL · L-2816

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

16356 COUNTY ROAD 41, Addison, AL 35540

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Other Identifiers 7

Other1225250640AL · United Health Care

OtherP00733325AL · Medicare Rr

OtherE869AL · Medicare Group

Medicaid111855AL

Other102I080435AL · Medicare

Medicare PINP00733325AL

Other1598717381AL · Medicaid Payee

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Terry Matthew James M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7214013259

PECOS Enrollment IDI20080401000039

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Terry James reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

James Enterprises, LLC

Same address

Family Medicine

16356 COUNTY ROAD 41
Addison, AL 35540

Reassigned Medicare billing, Alabama enrollment
6 clinicians in this Medicare group

NPI 1760785406 (256) 747-1186

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 19

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

569 services228 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

511 services97 patients

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

477 services82 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

343 services126 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

342 services180 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

215 services117 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

58 services51 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

51 services13 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

36 services36 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

33 services25 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

31 services25 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

30 services30 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

29 services25 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

19 services19 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

15 services13 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

11 services11 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

11 services11 patients

Blood glucose (sugar) test performed by hand-held instrument 82962

A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.

11 services11 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35540 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.90 typical visit price

range $52.65 – $161.63

Typical copayment $20.47 (range $13.16 – $40.40)

Most-billed visit code 99203

Established Patient

$93.72 typical visit price

range $16.56 – $131.65

Typical copayment $23.43 (range $4.14 – $32.91)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

14.94/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

Improvement Activities

Cost

49.8

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

11 suppliers57 claims110 services$5.65 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers24 claims24 services$0.99 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers38 claims38 services$20.21 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier16 claims17 services$8.73 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers56 claims56 services$114.84 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier15 claims15 services$35.61 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WHITNEY DYER

Nurse Practitioner (Family)

16356 COUNTY ROAD 41
ADDISON, AL 35540

Winston County (256) 747-1186

KARA EVERETT

Nurse Practitioner (Primary Care)

16356 COUNTY ROAD 41
ADDISON, AL 35540

Winston County (256) 747-1186

JAMES ENTERPRISES, LLC

Family Medicine

16356 COUNTY ROAD 41
ADDISON, AL 35540

Winston County (256) 747-1186

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Terry James's NPI number?

The NPI number for Terry James is 1225250640. It was assigned to this individual provider in the NPPES registry on May 3, 2007.

Where is Terry James located?

Terry James practices at 16356 County Road 41, Addison, AL 35540. The listed phone number is (256) 747-1186.

What is Terry James's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Terry James enrolled in Medicare?

Yes. Terry James is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Terry James's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Terry James reassigns Medicare benefits to James Enterprises, LLC (Addison, AL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Terry James's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Terry James accept?

Health plans from Ambetter Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama list Terry James as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Terry James was last updated on July 27, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.