MS. ELLEN J DEHAVEN (NPI# 1801104302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801104302 |
| Entity Type | Individual |
| Full Name | MS. ELLEN J DEHAVEN |
| Credential | FNP-BC |
| Practice Address |
3 Riverside Circle Carilion Clinic General and Breast Surgery Roanoke VA 24016 |
| Practice Telephone | 5402245170 |
| Practice Fax Number | 5409838212 |
| Mailing Telephone | 5402245170 |
| Mailing Fax Number | 5409838212 |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2011-04-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 0001195805 | VA | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024168977 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3 RIVERSIDE CIRCLE CARILION CLINIC GENERAL AND BREAST SURGERY |
| City | ROANOKE |
| State | VA |
| Zip Code | 24016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215939426 | Stephen Gordon Remine | Surgery | 3 Riverside Circle, Dept of Surgery, Roanoke, VA 24016 | 2005-06-01 |
| 1235756115 | Muhammad Fawwad Ahmed Hussain | Student in an Organized Health Care Education/Training Program | 3 Riverside Circle, Carilion Clinic Neurology, Roanoke, VA 24016 | 2020-06-26 |
| 1861650350 | Suzanna Connick Jamison | Internal Medicine | 3 Riverside Circle, Roanoke, VA 24016 | 2008-05-30 |
| 1891838249 | Paul Yeaton | Internal Medicine | 3 Riverside Circle, Lee Street, 1st Floor, Roanoke, VA 24016 | 2007-02-15 |
| 1295816544 | Ross William Murchison | Internal Medicine | 3 Riverside Circle, Roanoke, VA 24016 | 2006-10-17 |
| 1407946981 | James Schmidley | Psychiatry & Neurology | 3 Riverside Circle, Roanoke, VA 24016 | 2006-10-13 |
| 1659481984 | Lisa S Apfel | Neurological Surgery | 3 Riverside Circle, Roanoke, VA 24016 | 2006-08-30 |
| 1104831767 | Stanley Clifford Schold | Psychiatry & Neurology | 3 Riverside Circle, Roanoke, VA 24016 | 2006-07-30 |
| 1538180575 | Marrieth Garciela Rubio | Internal Medicine | 3 Riverside Circle, Va Gulf Coast Healthcare System (111), Roanoke, VA 24016 | 2006-07-23 |
| 1023053758 | Elvis Ramon Pagan | Internal Medicine | 3 Riverside Circle, Roanoke, VA 24016 | 2006-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134758329 | Davis Andrew Sugar | Student in an Organized Health Care Education/Training Program | 1 Riverside Circle, Suite 401, Roanoke, Va, 24016, Suite 401, Roanoke, VA 24016 | 2020-04-08 |
| 1356810659 | Susanne Tribble | Social Worker | 202 Wells Ave Nw, Roanoke, VA 24016 | 2018-11-15 |
| 1801305818 | Rena Lee Daye | Driver | 10 12th St. Sw, Roanoke, VA 24016 | 2017-09-21 |
| 1053841965 | Christin Elledge Clark | Nurse Practitioner | 1234 Franklin Road, Roanoke, VA 24016 | 2017-06-13 |
| 1235685884 | Helen Franck | Physical Therapist | 650 North Jefferson Street, Roanoke, VA 24016 | 2016-09-01 |
| 1457710238 | Frances Marie Gaeta | Social Worker | 360 Campbell Ave, Roanoke, VA 24016 | 2016-02-22 |
| 1982073292 | Sophie Mench Tranmer | Physical Therapist | 1421 Third St. Sw, Roanoke, VA 24016 | 2015-09-16 |
| 1982008181 | National Counseling Group, Inc | Psychiatry & Neurology | 20 Walnut Avenue, Roanoke, VA 24016 | 2014-10-17 |
| 1366858342 | National Counseling Group, Inc | Psychiatry & Neurology | 16 Walnut Avenue, Roanoke, VA 24016 | 2014-07-10 |
| 1427320878 | Kristen L. Jagger | Physical Medicine & Rehabilitation | 1015 First Street Sw Suite 2, Roanoke, VA 24016 | 2012-02-01 |
| Find all providers in zip 24016 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225638026 | Prasanti Pinnamaraju | Nurse Practitioner | 5324 Fox Ridge Rd, Roanoke, VA 24018-8754 | 2020-10-29 |
| 1912512856 | Jennifer Larson | Nurse Practitioner | 8325 Barrens Rd, Roanoke, VA 24019-6701 | 2020-09-08 |
| 1356953053 | Jamie Brackenrich | Nurse Practitioner | 6994 Dawnwood Rd, Roanoke, VA 24018-6839 | 2020-08-24 |
| 1164044608 | Denise Pollock | Nurse Practitioner | 6032 Matisse Ln, Roanoke, VA 24018-5335 | 2020-05-07 |
| 1538703061 | Erin Moyer Shinault | Nurse Practitioner | 3559 Meadowlark Rd, Roanoke, VA 24018-5007 | 2019-10-28 |
| 1972146421 | Amy Rose Gregor | Nurse Practitioner | 15645 Pioneer Bluff Trl, Roanoke, TX 76262-1799 | 2019-10-28 |
| 1811409402 | Victor Cisneros | Nurse Practitioner | 3535 Franklin Rd Sw, Roanoke, VA 24014-2255 | 2017-11-03 |
| 1053841965 | Christin Elledge Clark | Nurse Practitioner | 1234 Franklin Road, Roanoke, VA 24016 | 2017-06-13 |
| 1578009346 | Debra Jean Massaro | Nurse Practitioner | 123 Sesame St., Roanoke, VA 24011 | 2017-01-17 |
| 1407216831 | Keri Lynn Baker | Nurse Practitioner | 1 Riverside Cir Fl 4, Roanoke, VA 24016-4961 | 2016-02-26 |
| 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.