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

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: July 26, 2026.

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
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

Other Identifiers 7

Other1225250640AL · United Health Care
OtherP00733325AL · Medicare Rr
OtherE869AL · Medicare Group
Medicaid111855AL
Other102I080435AL · Medicare
Medicare PINP00733325AL
Other1598717381AL · Medicaid Payee

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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

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
Quality0
Improvement Activities0
Cost49.8

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.

Family Medicine
16356 COUNTY ROAD 41
ADDISON, AL 35540
Nurse Practitioner (Primary Care)
16356 COUNTY ROAD 41
ADDISON, AL 35540
Nurse Practitioner (Family)
16356 COUNTY ROAD 41
ADDISON, AL 35540

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.

What insurance does Terry James accept?

Health plans from Ambetter Health, Ambetter from Magnolia 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 with the weekly NPPES data releases published by CMS.