ADAM JAMES MD
NPI 1295364586
Family Medicine in Gallatin, TN

Q: What is Adam James's NPI number?

The NPI number for Adam James is 1295364586. It was assigned to this individual provider in the NPPES registry on April 7, 2020.

Q: What is Adam 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 Adam James was last updated on February 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 April 07, 2020PECOS EnrolledAccepts Medicare Assignment

225 BIG STATION CAMP BLVD, GALLATIN, TN 37066(615) 328-3400(615) 328-3416 Get Directions Write a Review

NPPES record last updated: February 8, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 8, 2024, Oct 19, 2023, Oct 10, 2023 and 1 more (4 updates tracked since 2020).

On this page

About Adam James Md NPPES

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

ADAM JAMES MD (NPI 1295364586) is an individual family medicine provider in Gallatin, Tennessee, licensed in Tennessee (68934) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with Sumner Regional Medical Center, and is a graduate of East Tennessee State University Quillen College Of Medicine (2020).

NPPES Registry Identity

NPI1295364586

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameADAM JAMESCredential: MD

Location Address225 BIG STATION CAMP BLVDGallatin, TN 37066-8464

Mailing Address225 Big Station Camp BlvdGallatin, TN 37066-8464 · (615) 328-3400 · Fax (615) 328-3416

Phone(615) 328-3400

Fax(615) 328-3416

Sole ProprietorNo

Medical School CMSEast Tennessee State University Quillen College Of MedicineGraduated 2020

Enumeration DateApril 7, 2020

Last NPPES UpdateFebruary 8, 20244 updates tracked since enumeration

NPPES CertifiedFebruary 8, 2024

✔ NPI 1295364586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TN · 68934

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.

225 BIG STATION CAMP BLVD, Gallatin, TN 37066

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter Health, Ambetter of Alabama 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 and accepts Medicare assignment

Adam James Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7416377965

PECOS Enrollment IDI20230913001136

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 Adam James reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sumner Physician Practices, LLC

Same address

Family Medicine

225 BIG STATION CAMP BLVD STE 206
Gallatin, TN 37066

Reassigned Medicare billing, Tennessee enrollment
110 clinicians in this Medicare group

NPI 1083097711 (615) 328-3400

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 4

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.

77 services53 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.

31 services29 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.

14 services14 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sumner Regional Medical Center

Acute Care Hospitals · Gallatin, TN

1/5 CMS rating

OwnershipProprietary

CMS Certification Number440003

Location555 Hartsville PikeGallatin, TN 37066 · Sumner County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37066 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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.

Other Providers at the Same Location NPPES 11

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

JEFFRIE C KINDRED DO

Family Medicine (Sports Medicine)

225 BIG STATION CAMP BLVD
GALLATIN, TN 37066

Sumner County (615) 328-3380

DANIELLE ALLEN MD

Pediatrics

225 BIG STATION CAMP BLVD
GALLATIN, TN 37066

Sumner County (615) 322-5000

SUMNER PHYSICIAN PRACTICES LLC

Family Medicine (Sports Medicine)

225 BIG STATION CAMP BLVD
GALLATIN, TN 37066

Sumner County (615) 328-3380

DR. MEGAN MICHELE MCCAULEY MD

Internal Medicine (Endocrinology, Diabetes & Metabolism)

225 BIG STATION CAMP BLVD, SUITE 206
GALLATIN, TN 37066

Sumner County (615) 328-3400

DR. BRITTANY CRIDER MD

Family Medicine

225 BIG STATION CAMP BLVD
GALLATIN, TN 37066

Sumner County (615) 328-3400

MRS. KAYLEE WOODALL MAYBERRY PA-C

Physician Assistant

225 BIG STATION CAMP BLVD
GALLATIN, TN 37066

Sumner County (615) 328-3400

PARIS ASHLEY YAMEK MD

Pediatrics

225 BIG STATION CAMP BLVD
GALLATIN, TN 37066

Sumner County (615) 322-5000

DIANNA L SHIPLEY MD

Internal Medicine (Medical Oncology)

225 BIG STATION CAMP BLVD, SUITE 201
GALLATIN, TN 37066

Sumner County (615) 451-5481

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 Adam James's NPI number?

The NPI number for Adam James is 1295364586. It was assigned to this individual provider in the NPPES registry on April 7, 2020.

Where is Adam James located?

Adam James practices at 225 Big Station Camp Blvd, Gallatin, TN 37066. The listed phone number is (615) 328-3400.

What is Adam James's specialty?

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

Is Adam James enrolled in Medicare?

Yes. Adam James is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Adam James's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Adam James reassigns Medicare benefits to Sumner Physician Practices, LLC (Gallatin, TN). 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 Adam James's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Adam James accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 2 other insurers list Adam 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.

Is Adam James affiliated with any hospitals?

According to CMS data, Adam James is affiliated with Sumner Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Adam James was last updated on February 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.