Organization Active NPI

Advanced Allergy and Asthma of Virginia

  • Allergy Physician
  • Midlothian, VA
National Provider Identifier
1104157114
Registry record updated May 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
0101038621 Issued in VA
Legal business name
ADVANCED ALLERGY AND ASTHMA OF VIRGINIA
Practice address
5924 Harbour Park Dr
Midlothian, VA 23112-2163
Phone
(804) 739-9005
NPI assigned
Jan 15, 2010
Last updated
May 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Barry Keith Feinstein, MDNPI 1023095411
Title
President
Phone
(804) 741-6900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 0101038621 VA Primary

Addresses

Primary practice location

5924 Harbour Park Dr
Midlothian, VA 23112-2163

Mailing address

5924 Harbour Park Dr
Midlothian, VA 23112-2163
Phone (804) 739-9005

Other identifiers 2

IdentifierTypeStateIssuer
029755OtherVAANTHEM
6000631MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100820000716 VA Part B Supplier - Clinic/Group Practice 3173657566 Receives reassigned benefits from 2 practitioners
Practice locations: Midlothian, VA; Glen Allen, VA

National Provider Directory

National Provider Directory

Locations

10120 W Broad St
Ste G
Glen Allen, VA 23060
Phone (804) 739-9005

5924 Harbour Park Dr
Midlothian, VA 23112
Phone (804) 739-9005

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274400000000",
    "number": "1104157114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5924 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122163",
            "telephone_number": "804-739-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5924 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122163",
            "telephone_number": "804-739-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ALLERGY AND ASTHMA OF VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-15",
        "last_updated": "2010-05-21",
        "status": "A",
        "authorized_official_last_name": "FEINSTEIN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-741-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "VA",
            "license": "0101038621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "029755",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000631",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.