SOUTH ROANOKE OB-GYN PC (NPI# 1598790115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598790115 |
| Entity Type | Organization |
| Organization Name | SOUTH ROANOKE OB-GYN PC |
| Practice Address |
2110 Carolina Ave Sw 3rd Floor Roanoke VA 24014-1702 |
| Mailing Address |
Po Box 8478 Roanoke VA 24014-0478 |
| Practice Telephone | 5403453556 |
| Practice Fax Number | 5403422193 |
| Mailing Telephone | 5403453556 |
| Mailing Fax Number | 5403422193 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2007-08-30 |
| Authorized Official Name | W KEVIN WALSH (PRESIDENT) |
| Authorized Official Telephone | 5403453556 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
0101237419 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM | 179613 | 01 |
| VA | RAILROAD MEDICARE | DD7281 | 01 |
| Street Address |
2110 CAROLINA AVE SW 3RD FLOOR |
| City | ROANOKE |
| State | VA |
| Zip Code | 24014-1702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649200130 | Jennifer E Walker | Chiropractor | 2110 Carolina Ave Sw, Roanoke, VA 24014-1738 | 2006-07-03 |
| 1508365875 | Nicole Marie Dougherty | Chiropractor | 2110 Carolina Ave Sw, Roanoke, VA 24014-1738 | 2018-02-01 |
| 1164966446 | Balance Wellspace Integrative Medicine, Inc. | General Practice | 2110 Carolina Ave Sw, Roanoke, VA 24014-1738 | 2016-12-06 |
| 1053763847 | Anna Occhiuzzi-flynn | Chiropractor | 2110 Carolina Ave Sw, Roanoke, VA 24014-1738 | 2016-07-06 |
| 1750750915 | Stephen Hussey | Chiropractor | 2110 Carolina Ave Sw, Roanoke, VA 24014-1738 | 2015-09-17 |
| 1154714764 | Kimberly Williams | Chiropractor | 2110 Carolina Ave Sw, Roanoke, VA 24014-1738 | 2015-03-07 |
| 1821192451 | Cape Chiropractic Inc | Chiropractor | 2110 Carolina Ave Sw, Roanoke, VA 24014-1738 | 2006-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558602 | Irene Pace Seidman | Pharmacist | 3350 Clearbrook Village Ln, Roanoke, VA 24014 | 2020-11-04 |
| 1720617970 | Mounica Reddy Thootkur | Student in an Organized Health Care Education/Training Program | 2017 South Jefferson Street, 2nd Floor, Roanoke, VA 24014 | 2020-04-08 |
| 1326675422 | Bharath Muppala | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2020-03-26 |
| 1235629239 | Sanjeeb Sudarshan Bhandari | Student in an Organized Health Care Education/Training Program | 1906 Bellview Ave Se, Roanoke, VA 24014 | 2018-05-15 |
| 1104325778 | Vera J. Short | Registered Nurse | 3167 Huffman Ln, Roanoke, VA 24014 | 2018-02-08 |
| 1770001380 | Michael Alan Phillips I | Social Worker | 2017 Jefferson Street, Roanoke, VA 24014 | 2017-09-03 |
| 1306362884 | Sara Alicia Guasch | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2017-08-16 |
| 1790212256 | Pouya Mafi | Student in an Organized Health Care Education/Training Program | 1906 Belleview Ave, Carilion Roanoke Memorial Hospital, Roanoke, VA 24014 | 2017-05-16 |
| 1790222867 | Mara Cate | Physician Assistant | 523 Arbuttus Ave, Roanoke, VA 24014 | 2017-01-26 |
| 1508314634 | Dknl Enterprises, Inc. | Non-emergency Medical Transport (VAN) | 3629 Franklin Rd Sw Suite 205b, Roanoke, VA 24014 | 2016-09-19 |
| Find all providers in zip 24014 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730589458 | Drs Moore & Stockstill PC | Obstetrics & Gynecology | 5104 Bernard Dr, Suite 301, Roanoke, VA 24018-4349 | 2014-08-29 |
| 1629082839 | W Robert Wisman | Obstetrics & Gynecology | 1506 Franklin Rd Sw, Roanoke, VA 24016-5207 | 2006-07-27 |
| 1598740342 | William Watson Pasley | Obstetrics & Gynecology | 1231 S Jefferson St, Roanoke, VA 24016-4705 | 2005-12-14 |
| 1376878850 | Barbara Carol Moore | Obstetrics & Gynecology | 1240 3rd St Sw, Roanoke, VA 24016-4612 | 2009-10-16 |
| 1255413027 | Lewis-gale Physicians, LLC | Obstetrics & Gynecology | 1231 S Jefferson St, Roanoke, VA 24016-4705 | 2006-10-20 |
| 1447247457 | Mark William Chewning | Obstetrics & Gynecology | 21 Highland Ave Se, Suite 200, Roanoke, VA 24013-2201 | 2005-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013530435 | Center for Endometriosis and Advanced Pelvic Surgery | Obstetrics & Gynecology | 6801 Whittier Ave Ste 301, Mc Lean, VA 22101-4549 | 2020-05-20 |
| 1891217857 | Loudoun Medical Group PC | Obstetrics & Gynecology | 3301 Woodburn Rd Ste 309, Annandale, VA 22003-7308 | 2017-07-12 |
| 1285093070 | Loudoun Medical Group PC | Obstetrics & Gynecology | 8292 Old Courthouse Rd, Suite C, Vienna, VA 22182-3834 | 2016-02-22 |
| 1649694993 | Carol Ciofalo | Obstetrics & Gynecology | 5209 11th Rd N, Arlington, VA 22205-2424 | 2014-02-06 |
| 1063754554 | Westhampton Health and Wellness LLC | Obstetrics & Gynecology | 2000 Bremo Rd # 205a, Richmond, VA 23226-2440 | 2013-03-22 |
| 1316212889 | Lisa Ruth Himmelstein | Obstetrics & Gynecology | 2515 Londonderry Rd, Alexandria, VA 22308-2332 | 2012-03-17 |
| 1265700769 | Jerome Frank Strauss IIi | Obstetrics & Gynecology | 2805 Monument Ave Apt 3, Richmond, VA 23221-1737 | 2011-12-12 |
| 1548592397 | Womens Health and Wellness LLC | Obstetrics & Gynecology | 6506 Main St, Gloucester, VA 23061-6103 | 2010-02-04 |
| 1467686907 | Millennium Gynecology P.l.l.c. | Obstetrics & Gynecology | 3359 Roundtree Estates Ct, Falls Church, VA 22042-3550 | 2009-05-12 |
| 1972785053 | Bon Secours-virginia Healthsource Inc | Obstetrics & Gynecology | 8266 Atlee Rd Ste 215, Mechanicsville, VA 23116-1805 | 2007-11-30 |
| Find all providers with the same taxonomy | ||||
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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.