Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

James William Southam, NP-C, FNP

Individual provider Family Nurse Practitioner · NPI 1598301582

James William Southam, NP-C, FNP is a Nurse Practitioner in Roseburg, Oregon. Qualified in 2019, 7 years ago. Practices with Icco LLC, a 133-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
7
Licensed in
OR
In the registry since
2019
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

1740 NW Goetz St
Roseburg, OR 97471-1613
Phone: (541) 640-7625
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 201906644NP-PP (OR)

Record details

NPI number1598301582
Entity typeIndividual (Type 1)
GenderMale
Credentials NP-C , FNP
Sole proprietorNo
NPI enumeratedNovember 25, 2019
Last updated in NPPESJanuary 24, 2020
Certification dateJanuary 24, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Icco Llc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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