MARY C. VANDERGRIFT (NPI# 1518041722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518041722 |
| Entity Type | Individual |
| Full Name | MARY C. VANDERGRIFT |
| Other Name | MARY C. KISER |
| Credential | PA-C |
| Practice Address |
5673 Airport Rd Roanoke VA 24012-1119 |
| Practice Telephone | 5405238080 |
| Practice Fax Number | 5405628867 |
| Mailing Telephone | 5405238080 |
| Mailing Fax Number | 5405628867 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2016-06-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0110002290 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | DEA NUMBER | MK1486100 | 01 |
| Street Address |
5673 AIRPORT RD |
| City | ROANOKE |
| State | VA |
| Zip Code | 24012-1119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922021625 | David Scott Hungate | Physician Assistant | 5673 Airport Rd, Roanoke, VA 24012-1119 | 2006-07-25 |
| 1538701297 | Melinda Turner Black | Counselor | 5673 Airport Rd, Roanoke, VA 24012-1119 | 2019-10-15 |
| 1720640832 | Amanda Buchmeier | Behavioral Analyst | 5673 Airport Rd, Roanoke, VA 24012-1119 | 2019-06-28 |
| 1275197980 | Rashadah Jordan | Physician Assistant | 5673 Airport Rd, Roanoke, VA 24012-1119 | 2019-04-29 |
| 1053882985 | Whitney Erin Gendron Walker | Counselor | 5673 Airport Rd, Roanoke, VA 24012-1119 | 2018-12-17 |
| 1528539715 | Michael Carter | Marriage & Family Therapist | 5673 Airport Rd, Roanoke, VA 24012-1119 | 2018-12-16 |
| 1417422791 | Courtney Canterbury Ashby | Counselor | 5673 Airport Rd, Roanoke, VA 24012-1119 | 2018-10-12 |
| 1871093401 | Jenna Nicole Crozier | Physician Assistant | 5673 Airport Rd, Roanoke, VA 24012-1119 | 2018-02-20 |
| 1700391604 | Brandon Rose | Social Worker | 5673 Airport Rd, Roanoke, VA 24012-1119 | 2017-12-13 |
| 1295249944 | Mary Beth Overstreet | Counselor | 5673 Airport Rd, Roanoke, VA 24012-1119 | 2017-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215440359 | Sahar Rafiq | Dentist | 3802 Apricot Trl, Roanoke, VA 24012 | 2017-11-12 |
| 1790202695 | Friendship Pharmacy, Inc. | Pharmacy | 327 Hershberger Rd., Roanoke, VA 24012 | 2017-08-23 |
| 1760912901 | Odyssey Healthcare Operating B, Lp | Hospice Care, Community Based | 1318 Plantation Rd Ne, Roanoke, VA 24012 | 2017-06-19 |
| 1770019622 | Eisa Jawad Abu Munshar | Dentist | 4753 Valley View Blvd Nw, Roanoke, VA 24012 | 2017-05-11 |
| 1447702303 | Kartesz Eye Associates Inc. | Optometrist | 4922 Vally View Blvd., Roanoke, VA 24012 | 2016-10-26 |
| 1740638220 | Kevin E Steinberger | Physical Therapist | 2730 Forest Oak Dr, Roanoke, VA 24012 | 2016-05-25 |
| 1740637883 | Professional Health Care Services, Inc. | In Home Supportive Care | 367 Hershberger Rd., Nw, Roanoke, VA 24012 | 2016-05-18 |
| 1497129787 | M Zaher Aymach | Dentist | 1502 Williamson Rd Ne Ste A, Roanoke, VA 24012 | 2015-11-24 |
| 1518223916 | Katherine Rash | Social Worker | 3003 Hollins Road, Roanoke, VA 24012 | 2012-04-10 |
| 1841525383 | William Kastern, O.d., Ph.d., LLC | Optometrist | 4822c Valley View Blvd., Roanoke, VA 24012 | 2009-10-15 |
| Find all providers in zip 24012 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164040960 | Daniel Scott Feivor | Physician Assistant | 131 Campbell Ave Sw Ste 215, Roanoke, VA 24011-1241 | 2020-07-08 |
| 1275159287 | Paige Alexandra Hamay | Physician Assistant | 206 Williamson Rd Se Apt 227, Roanoke, VA 24011-1812 | 2020-06-25 |
| 1396360624 | Hannah Barnhill | Physician Assistant | 943 Murray Ave Se, Roanoke, VA 24013-1841 | 2020-06-12 |
| 1922623297 | Grace G Krotkov | Physician Assistant | 3410 Chaparral Dr Apt 133, Roanoke, VA 24018-4930 | 2020-06-12 |
| 1639791270 | Megan Thorn | Physician Assistant | 502 Allison Ave Sw Apt 5, Roanoke, VA 24016-4547 | 2020-05-16 |
| 1952923914 | Sydney Lucille Hughes Adams | Physician Assistant | 928 2nd St Sw Apt 1, Roanoke, VA 24016-4420 | 2020-05-13 |
| 1780206268 | Katherine Cole | Physician Assistant | 16 Old Whitmore Ave Se Apt 507, Roanoke, VA 24016-1236 | 2020-05-07 |
| 1205457033 | Kristin Marie Sammons | Physician Assistant | 6430 Archcrest Dr Apt 107, Roanoke, VA 24019-1185 | 2020-05-04 |
| 1407480460 | Amanda Joy Wheeler | Physician Assistant | 3626 Belle Ave Ne, Roanoke, VA 24012-6408 | 2020-02-28 |
| 1356981625 | Ryan Maurer Short | Physician Assistant | 1615 Westover Ave Sw # A, Roanoke, VA 24015-5215 | 2020-01-14 |
| Find all providers in ROANOKE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.