1205899127 NPI number — DR. JAMES MCMURTRY M.D.

Table of content: DR. JAMES MCMURTRY M.D. (NPI 1205899127)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205899127 NPI number — DR. JAMES MCMURTRY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCMURTRY
Provider First Name:
JAMES
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205899127
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/15/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9101 STONY POINT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-330-9105
Provider Business Mailing Address Fax Number:
804-287-6119

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9101 STONY POINT DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-330-9105
Provider Business Practice Location Address Fax Number:
804-287-6119
Provider Enumeration Date:
04/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  0101 042577 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 007500939 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 212762 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 35755 . This is a "ALLIANCE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: C04008 . This is a "MEDICARE GROUP #" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 56383 . This is a "CARENET" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 45727 . This is a "SENTARA FAMILY CARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 790528 . This is a "AETNA HMO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 340009881 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4063594 . This is a "AETNA PPO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: CL9160 . This is a "RAILROAD MEDICARE GROUP #" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 080220000-00 . This is a "QUALCHOICE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1900004 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 59339 . This is a "SOUTHERN HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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