James Madison University
Organization Active NPI Clinical Psychologist · Luray, VA
NPI 1730642000 · NPPES record last updated Apr 12, 2019
Key facts
- NPI
- 1730642000
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- Legal business name
- JAMES MADISON UNIVERSITY
- Practice address
- 250 Memorial Drive
Suite B
Luray, VA 22835 - Phone
- (540) 568-1735
- Fax
- (540) 568-8866
- NPI assigned
- Apr 12, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- JAMES MADISON UNIVERSITY
Authorized official
- Name
- Kris Christophel, CPC, CPB
- Title
- Clinical Billing Coordinator
- Phone
- (540) 568-2621
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 6
Practitioners 15
-
Timothy J Schulte, PSY. D.
-
Melissa Garber, AU.D.
-
Charles Miller, PSY.D., LCP
-
Emily C Pastore, AUD
-
Thomas Michael Newman, PHD, LAT, ATC
-
Shelly-Ann Nicola Peart James, PSYD, LCP
-
Jordan Otto, MA, ED.S
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200121000225 | VA | Part B Supplier - Clinic/Group Practice | 4880917475 |
Receives reassigned benefits from 1 practitioner Practice locations: Luray, VA |
National Provider Directory
- Tax ID family
- James Madison University Shenandoah Valley Child Development Clinic
- Part of
- James Madison University Shenandoah Valley Child Development Clinic
Locations
235 Martin Luther King Jr Way
#4304
Harrisonburg, VA 22807
Phone (540) 568-6491
755 Martin Luther King Jr Hwy
Harrisonburg, VA 22807
Phone (540) 568-1735
131 W Grace St
Rm 1101
Harrisonburg, VA 22807
Phone (540) 568-4980
755 Martin Luther King Jr Hwy
#9012
Harrisonburg, VA 22807
Phone (540) 568-1735
235 Martin Luther King Jr Way
Harrisonburg, VA 22807
Phone (540) 568-2395
294 E Main St
Stanley, VA 22851
Phone (434) 990-1744
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | Yes |
Addresses
Primary practice location
250 Memorial Drive
Suite B
Luray, VA 22835
Mailing address
755 Martin Luther King, Jr. Way
MSC 9012
Harrisonburg, VA 22801-0001
Phone (540) 568-1735
Other practice location 1
294 E Main St
Stanley, VA 22851-4039
Phone (540) 568-1735
Other practice location 2
755 Martin Luther King, Jr. Way
MSC 9012
Harrisonburg, VA 22801-0001
Phone (540) 568-1735
Other names
- Rural Health Psychology Clinic
Other providers in Luray, VA
- Fang Shuh Horng
- Angie Rae House
- Walter Wesley Howard
- Muhammad Jamal
- James G. Dale, D.O.
- James W. Feeley, III, M.D.
- Ami G Jani
- Earl Jenkins
- Catherine Winn Jennings
- Jennifer Leigh Kelly
All providers in Luray, VA · Clinical Psychologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.