NPIMap

Organization Active NPI

James Madison University

Doing business as Rural Health Psychology Clinic

  • Clinical Psychologist
  • Luray, VA
National Provider Identifier
1730642000
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
JAMES MADISON UNIVERSITY
Doing business as
Rural Health Psychology Clinic
Practice address
250 Memorial Drive
Suite B
Luray, VA 22835
Phone
(540) 568-1735
Fax
(540) 568-8866
NPI assigned
Apr 12, 2019
Last updated
Apr 12, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
JAMES MADISON UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Authorized official

Name
Kris Christophel, CPC, CPB
Title
Clinical Billing Coordinator
Phone
(540) 568-2621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

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

755 Martin Luther King, Jr. Way
MSC 9012
Harrisonburg, VA 22801-0001
Phone (540) 568-1735

Other practice location 2

294 E Main St
Stanley, VA 22851-4039
Phone (540) 568-1735

Other names 1

  • Rural Health Psychology Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200121000225 VA Part B Supplier - Clinic/Group Practice 4880917475 Receives reassigned benefits from 1 practitioner
Practice locations: Luray, VA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
James Madison University7 organizations share this tax ID, including this one
Part of
James Madison University

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

131 W Grace St
Rm 1101
Harrisonburg, VA 22807
Phone (540) 568-4980

235 Martin Luther King Jr Way
#4304
Harrisonburg, VA 22807
Phone (540) 568-6491

755 Martin Luther King Jr Hwy
#9012
Harrisonburg, VA 22807
Phone (540) 568-1735

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555027200000",
    "number": "1730642000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 MARTIN LUTHER KING, JR. WAY",
            "address_2": "MSC 9012",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228010001",
            "telephone_number": "540-568-1735",
            "fax_number": "540-568-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MEMORIAL DRIVE",
            "address_2": "SUITE B",
            "city": "LURAY",
            "state": "VA",
            "postal_code": "22835",
            "telephone_number": "540-568-1735",
            "fax_number": "540-568-8866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "755 Martin Luther King, Jr. Way",
            "address_2": "MSC 9012",
            "address_purpose": "LOCATION",
            "city": "Harrisonburg",
            "state": "VA",
            "postal_code": "228010001",
            "country_code": "US",
            "telephone_number": "540-568-1735",
            "fax_number": "540-568-8866",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "294 E Main St",
            "address_purpose": "LOCATION",
            "city": "Stanley",
            "state": "VA",
            "postal_code": "228514039",
            "country_code": "US",
            "telephone_number": "540-568-1735",
            "fax_number": "540-568-8866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAMES MADISON UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JAMES MADISON UNIVERSITY",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A",
        "authorized_official_last_name": "CHRISTOPHEL",
        "authorized_official_first_name": "KRIS",
        "authorized_official_title_or_position": "CLINICAL BILLING COORDINATOR",
        "authorized_official_telephone_number": "540-568-2621",
        "authorized_official_credential": "CPC, CPB"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rural Health Psychology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Luray, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.