JAMES DUSTIN DENHAM
NPI 1801356365
Internal Medicine in Atlanta, GA

Active since March 21, 2019PECOS EnrolledAccepts Medicare Assignment
71.56/100
CMS Quality Rating
49 JESSE HILL JR DR SE, ATLANTA, GA 30303(404) 778-7777 Get Directions Write a Review

NPPES record last updated: December 26, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 11, 2022, Mar 21, 2019 (2 updates tracked since 2019).

About James Dustin Denham NPPES

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

JAMES DUSTIN DENHAM (NPI 1801356365) is an individual internal medicine provider in Atlanta, Georgia, licensed in Ohio (35.146090) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, is affiliated with Sagewest Health Care, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1801356365
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJAMES DUSTIN DENHAM
Location Address49 JESSE HILL JR DR SEAtlanta, GA 30303-3049
Mailing Address49 Jesse Hill Jr Dr SeAtlanta, GA 30303-3049 · (404) 778-7777
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMarch 21, 2019
Last NPPES UpdateDecember 26, 20232 updates tracked since enumeration
NPPES CertifiedDecember 26, 2023
NPI 1801356365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses Licensed in OH · 35.146090 Licensed in WY · 14435A
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

49 JESSE HILL JR DR SE, Atlanta, GA 30303

Secondary Practice Locations 2

Location 1400 S 15th StWorland, WY 82401-3531 · Phone (307) 347-3321 · Fax (866) 368-6349
Location 2615 Fulton StPort Clinton, OH 43452-2001 · Phone (419) 734-3131 · Fax (866) 368-6349

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

James Dustin Denham 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 ID4789060195
PECOS Enrollment IDI20221012003479
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 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
706 services287 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
535 services253 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
345 services316 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
117 services115 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
32 services24 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
21 services15 patients

Hospital Affiliations CMS Care Compare 3

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

Sagewest Health Care

Acute Care Hospitals · Riverton, WY
1/5 CMS rating
OwnershipProprietary
CMS Certification Number530008
Location2100 W Sunset DrRiverton, WY 82501 · Fremont County
Emergency services

Wyoming Medical Center

Acute Care Hospitals · Casper, WY
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number530012
Location1233 East 2nd StCasper, WY 82601 · Natrona County
Emergency services Birthing friendly

Washakie Medical Center

Critical Access Hospitals · Worland, WY
OwnershipGovernment - Local
CMS Certification Number531306
Location400 South 15th StreetWorland, WY 82401 · Washakie County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30303 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

71.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality66.54
Improvement Activities40

Other Providers at the Same Location NPPES 20

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

Internal Medicine (Endocrinology, Diabetes & Metabolism)
49 JESSE HILL JR DR SE
ATLANTA, GA 30303
Internal Medicine
49 JESSE HILL JR DR SE
ATLANTA, GA 30303
Neurological Surgery
49 JESSE HILL JR DR SE, FACULTY OFFICE BUILDING #337
ATLANTA, GA 30303
Internal Medicine
49 JESSE HILL JR DR SE, EMORY UNIV. FACULTY OFFICE BLDG
ATLANTA, GA 30303
Pediatrics
49 JESSE HILL JR DR SE
ATLANTA, GA 30303
Internal Medicine (Rheumatology)
49 JESSE HILL JR DR SE, RHEUMATOLOGY
ATLANTA, GA 30303
Internal Medicine (Infectious Disease)
49 JESSE HILL JR DR SE
ATLANTA, GA 30303
Orthopaedic Surgery (Orthopaedic Trauma)
49 JESSE HILL JR DR SE, SUITE 319
ATLANTA, GA 30303

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 James Denham's NPI number?

The NPI number for James Denham is 1801356365. It was assigned to this individual provider in the NPPES registry on March 21, 2019.

Where is James Denham located?

James Denham practices at 49 Jesse Hill Jr Dr SE, Atlanta, GA 30303. The listed phone number is (404) 778-7777.

What is James Denham's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is James Denham enrolled in Medicare?

Yes. James Denham 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.

Is James Denham affiliated with any hospitals?

According to CMS data, James Denham is affiliated with Sagewest Health Care, Wyoming Medical Center and Washakie Medical Center.

When was this NPI record last updated?

The NPPES record for James Denham was last updated on December 26, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.