DR. DAVID H. MORTLOCK (NPI# 1861691552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861691552 |
| Entity Type | Individual |
| Full Name | DR. DAVID H. MORTLOCK |
| Practice Address |
4910 Valley View Blvd Nw Roanoke VA 24012-2040 |
| Practice Telephone | 5402651607 |
| Practice Fax Number | 5403667353 |
| Mailing Telephone | 5402651607 |
| Mailing Fax Number | 5403667353 |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2010-09-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 116019067 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1861691552 | 05 |
| Street Address |
4910 VALLEY VIEW BLVD NW |
| City | ROANOKE |
| State | VA |
| Zip Code | 24012-2040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164409652 | John Daugherty | Family Medicine | 4910 Valley View Blvd Nw, Roanoke, VA 24012-2040 | 2005-12-27 |
| 1851920607 | Peter Hartung | Student in an Organized Health Care Education/Training Program | 4910 Valley View Blvd Nw, Roanoke, VA 24012-2040 | 2020-04-03 |
| 1336609155 | Mitesh Patel | Student in an Organized Health Care Education/Training Program | 4910 Valley View Blvd Nw, 3rd Floor, Roanoke, VA 24012 | 2019-03-20 |
| 1275092660 | Teana Harris | Student in an Organized Health Care Education/Training Program | 4910 Valley View Blvd Nw, Roanoke, VA 24012-2040 | 2019-03-15 |
| 1770002172 | William Edward Pauley IIi | Nurse Practitioner | 4910 Valley View Blvd Nw, Roanoke, VA 24012 | 2017-09-17 |
| 1447789425 | Hilary L Linderman | Psychologist | 4910 Valley View Blvd Nw, Roanoke, VA 24012 | 2017-06-05 |
| 1053869271 | Samantha Smart | Nurse Practitioner | 4910 Valley View Blvd Nw, Roanoke, VA 24012-2040 | 2016-09-16 |
| 1740644673 | Abigail Lubin | Family Medicine | 4910 Valley View Blvd Nw, Roanoke, VA 24012 | 2016-04-06 |
| 1821471459 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 4910 Valley View Blvd Nw, Suite L, Roanoke, VA 24012-2040 | 2015-07-01 |
| 1730509944 | Tara Wickline Stone | Nurse Practitioner | 4910 Valley View Blvd Nw, Roanoke, VA 24012-2040 | 2014-04-27 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083247555 | Lisa R Zettler | Family Medicine | 1016 Primrose Ave Se, Roanoke, VA 24014-2508 | 2020-02-12 |
| 1316581366 | Dustin Powers | Family Medicine | 3347 Pamlico Dr, Roanoke, VA 24018-4938 | 2019-11-03 |
| 1932692365 | Sarah Rebecca Childress | Family Medicine | 102 Highland Ave Se Ste 303, Roanoke, VA 24013-2253 | 2018-06-11 |
| 1013327188 | The Center for Ultra Health LLC | Family Medicine | 4235 Colonial Ave, First Floor, Roanoke, VA 24018-4002 | 2014-04-29 |
| 1679904338 | Mazen Madhoun Md LLC | Family Medicine | 6002 Winnbrook Ln, Roanoke, VA 24018-7907 | 2013-12-06 |
| 1245563519 | Valley Gericare Inc | Family Medicine | 1205 Moorman Ave Nw, Roanoke, VA 24017-5739 | 2009-09-17 |
| 1003149915 | Valley Gericare Inc | Family Medicine | 2917 Penn Forest Blvd, Ste 518, Roanoke, VA 24018-4374 | 2009-09-09 |
| 1679774582 | Beau James Ellenbecker | Family Medicine | 610 E Byron Nelson Blvd, Suite 101, Roanoke, TX 76262-6541 | 2007-05-29 |
| 1962535278 | Jeffrey Brad Griffin | Family Medicine | 509 E Byron Nelson Blvd, Suite B, Roanoke, TX 76262-6183 | 2007-03-14 |
| 1043349384 | Janet Lee Spitzer | Family Medicine | 1901 Denniston Ave Sw, Roanoke, VA 24015-2023 | 2007-03-04 |
| 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.