DR. JAMES GILBERT ATHERTON M.D.
NPI 1679746119
Pediatrics - Pediatric Nephrology in Memphis, TN
NPI Status: Active since April 04, 2008
Contact Information
51 N DUNLAP ST
STE. 400
MEMPHIS, TN
ZIP 38105
Phone: (901) 287-7337
Fax: (901) 287-4587
- Individual
- Male
- Years of Experience 18
- Pediatrics
- Pediatric Nephrology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About JAMES ATHERTON
This page provides the complete NPI Profile along with additional information for James Atherton, a pediatrician established in Memphis, Tennessee with a medical specialization in Pediatrics, focusing in pediatric nephrology and more than 18 years of experience. The healthcare provider is registered in the NPI registry with number 1679746119 assigned on April 2008. The practitioner's primary taxonomy code is 2080P0210X with license number 48674 (TN). The provider is registered as an individual and his NPI record was last updated 8 years ago.
- NPI
- 1679746119
- Provider Name
- DR. JAMES GILBERT ATHERTON M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 51 N DUNLAP ST STE. 400 MEMPHIS, TN 38105
- Location Phone
- (901) 287-7337
- Location Fax
- (901) 287-4587
- Mailing Address
- 850 POPLAR AVE BLDG. 2 MEMPHIS, TN 38105
- Mailing Phone
- (901) 287-5674
- Mailing Fax
- (901) 287-4587
- Medical School Name
- OTHER
- Graduation Year
- 2008
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-04-2008
- Last Update Date
- 06-07-2018
- Code Navigator
A pediatrician like James Atherton is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics Pediatric Nephrology
- Taxonomy Code
- 2080P0210X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 48674
- License State
- TN
- Taxonomy Description
- A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- SoloCare Bronze EPO $8500 DED HSA 10004 - EPO
- SoloCare Exp Bronze EPO $9500 DED 10015 - EPO
- SoloCare Gold EPO $1500 DED 10010 - EPO
- SoloCare Silver EPO $5000 DED 10014 - EPO
- SoloCare Silver EPO $6500 DED 10013 - EPO
- SoloCare Standard Exp Bronze EPO $7500 DED 10008 - EPO
- SoloCare Standard Gold EPO $2000 DED 10006 - EPO
- SoloCare Standard Platinum EPO $0 DED 10005 - EPO
- SoloCare Standard Silver EPO $6000 DED 10007 - EPO
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Essential (No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Gold Advantage (Virtual Urgent Care, No Referrals) - EPO
- UHC Gold Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus (Virtual Urgent Care, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Silver Advantage (Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Silver Copay Focus (Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Standard (No Referrals) - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
James Atherton is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
James Atherton is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 4385961630
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20150325000911
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Reviews for DR. JAMES GILBERT ATHERTON M.D.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1679746119, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MEMPHIS, TN 38105
MEMPHIS, TN 38105
MEMPHIS, TN 38105
MEMPHIS, TN 38105
MEMPHIS, TN 38105
MEMPHIS, TN 38105
MEMPHIS, TN 38105
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1679746119, enumerated as an "individual" on April 04, 2008.
The provider is located at 51 N DUNLAP ST STE. 400 MEMPHIS, TN 38105 and the phone number is (901) 287-7337.
Pediatrics with taxonomy code 2080P0210X and a focus in Pediatric Nephrology.
The provider might be accepting Accepts: Alliant Health Plans, Inc., BlueCross BlueShield. Please consult your insurance carrier or call the provider to verify.
