William J. McAveney, M.D.

Key facts

NPI

1831246891

Entity type

Individual (NPI type 1)

Primary specialty

Pediatric Adolescent Medicine Physician 2080A0000X

License

0101030932 (VA)

Practice address

221 Randolph St
Mineral, VA 23117-4493

Phone

(540) 872-2638

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Medicine

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831246891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10623 CRESTWOOD DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 RANDOLPH ST",
            "city": "MINERAL",
            "state": "VA",
            "postal_code": "231174493",
            "telephone_number": "540-872-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCAVENEY",
        "first_name": "WILLIAM",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "VA",
            "license": "0101030932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "0101030932",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Mineral, VA · Pediatric Adolescent Medicine Physician in Virginia