Basic Information
Provider Information | |||||||||
NPI: | 1366878746 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | MCNEELY | ||||||||
FirstName: | JAMES | ||||||||
MiddleName: | C | ||||||||
NamePrefix: | MR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | CRNP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1000 BOWER HILL RD | ||||||||
Address2: | ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN | ||||||||
City: | PITTSBURGH | ||||||||
State: | PA | ||||||||
PostalCode: | 152431873 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4129422548 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 733 WASHINGTON RD | ||||||||
Address2: | SUITE 401 | ||||||||
City: | PITTSBURGH | ||||||||
State: | PA | ||||||||
PostalCode: | 152282022 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4123431770 | ||||||||
FaxNumber: | 4123433280 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/17/2013 | ||||||||
LastUpdateDate: | 04/19/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 04/19/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | SP013195 | PA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 363LF0000X | SP013195 | PA | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.