Basic Information
| Provider Information | |||||||||
| NPI: | 1962566208 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JAMES W. FEELEY, III, M.D. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | PAGE PRIMARY CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 MEMORIAL DR | ||||||||
| Address2: | SUITE B | ||||||||
| City: | LURAY | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228351000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5407439087 | ||||||||
| FaxNumber: | 5407431195 | ||||||||
| Practice Location | |||||||||
| Address1: | 250 MEMORIAL DR | ||||||||
| Address2: | SUITE B | ||||||||
| City: | LURAY | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228351000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5407439087 | ||||||||
| FaxNumber: | 5407431195 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2006 | ||||||||
| LastUpdateDate: | 06/16/2008 | ||||||||
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| AuthorizedOfficialLastName: | FEELEY | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | WILLIAM | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5407439087 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | III | ||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 001158166 | VA | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 005607850 | 05 | VA | MEDICAID | 1649272147 | 01 | VA | NPI--JAMES FEELEY III MD | OTHER | 1730178773 | 01 | VA | NPI DEBORAH FORREST NP | OTHER |