1891018917 NPI number — JAMES MADISON UNIVERSITY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891018917 NPI number — JAMES MADISON UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES MADISON UNIVERSITY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
JMU OCCUPATIONAL THERAPY CLINICAL EDUCATION SERVICES
Provider Other Organization Name Type Code:
3
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:
1891018917
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
JMU MSC 9022
Provider Second Line Business Mailing Address:
755 MLK JR. WAY
Provider Business Mailing Address City Name:
HARRISONBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22801-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-568-7749
Provider Business Mailing Address Fax Number:
540-568-6409

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
131 W GRACE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISONBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22807-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-568-7749
Provider Business Practice Location Address Fax Number:
540-568-6409
Provider Enumeration Date:
03/03/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BONHAM
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
540-568-4980

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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