Active NPI
Marissa Laurette Feeney, MD
- Forensic Pathology Physician
- Vandalia, IL
National Provider Identifier
1669014189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Pathology Physician
- License
- 036.141060
- Practice address
- 692 E 1700 Ave
Vandalia, IL 62471-4028 - Phone
- (618) 704-5945
- Fax
- (888) 618-8106
- NPI assigned
- Oct 16, 2019
- Last updated
- Oct 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Pathology Physician | 207ZF0201X | 036.141060 | IL | Primary |
Addresses
Primary practice location
692 E 1700 Ave
Vandalia, IL 62471-4028
Mailing address
692 E 1700 Ave
Vandalia, IL 62471-4028
Phone (618) 704-5945
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.141060 | IL | MD | Forensic Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571184000000",
"number": "1669014189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "692 E 1700 AVE",
"city": "VANDALIA",
"state": "IL",
"postal_code": "624714028",
"telephone_number": "618-704-5945",
"fax_number": "888-618-8106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "692 E 1700 AVE",
"city": "VANDALIA",
"state": "IL",
"postal_code": "624714028",
"telephone_number": "618-704-5945",
"fax_number": "888-618-8106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEENEY",
"first_name": "MARISSA",
"middle_name": "LAURETTE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-16",
"last_updated": "2019-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207ZF0201X",
"taxonomy_group": "",
"desc": "Pathology, Forensic Pathology",
"state": "IL",
"license": "036.141060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vandalia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.