NPIMap

Individual provider Active NPI

Lindsay R Wilson, DO

  • Family Medicine Physician
  • Roanoke, VA
National Provider Identifier
1003044694
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102203035 Issued in VA
Practice address
1314 Peters Creek Rd NW
Roanoke, VA 24017-2500
Phone
(540) 562-5703
Fax
(540) 562-4278
NPI assigned
Jun 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 0102203035 VA
Hospitalist Physician 208M00000X 0102203035 VA
Family Medicine Physician 207Q00000X 0102203035 VA Primary

Addresses

Primary practice location

1314 Peters Creek Rd NW
Roanoke, VA 24017-2500

Mailing address

1314 Peters Creek Rd NW
Roanoke, VA 24017-2500
Phone (540) 562-5703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131002000491 VA Practitioner - Family PracticePractitioner - Hospice/Palliative Care 2163656232 Reassigns benefits to 3 organizations
I20210709001883 TN Practitioner - Hospice/Palliative CarePractitioner - Family Practice 2163656232 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospice/Palliative Care
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians
Blue Ridge Medical Management CorporationGroup PAC ID 9739099441, 283 clinicians
WPS Providers IncGroup PAC ID 7719079532, 83 clinicians

Practice addresses (Care Compare)

16000 Johnson Memorial Dr
Abingdon, VA 24211-7664

1990 Holton Ave E
Big Stone Gap, VA 24219-3350
Phone (423) 230-8200

245 Medical Park Dr
Marion, VA 24354-1100

3 Professional Park Dr
Suite 31
Johnson City, TN 37604-6529
Phone (423) 434-3570

323 Falls NWDR
Abingdon, VA 24210-8093
Phone (276) 628-2612

Hospital & facility affiliations

  • Ballad Health Hospice Hospice, Abingdon, VA, CCN 491542
  • Ballad Health Hospice Hospice, Bristol, TN, CCN 441558
  • Johnston Memorial Hospital Hospital, Abingdon, VA, CCN 490053
  • Russell County Hospital Hospital, Lebanon, VA, CCN 490002
  • Smyth County Community Hospital Hospital, Marion, VA, CCN 490038
  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102203035VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince Aug 20, 2021 Accepting new patients
Blue Ridge Medical Managment Corporation CurrentSince Jul 12, 2015 Accepting new patients
Wellmont Medical Associates Inc Family Medicine CurrentSince Aug 20, 2021 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Aug 20, 2021 Accepting new patients
WPS Providers Inc CurrentSince Jan 1, 2024 Accepting new patients
Wellmont Medical Associates Inc Family Medicine CurrentSince Aug 20, 2021 Accepting new patients
Blue Ridge Medical Management Corporation Family Medicine CurrentSince Jul 12, 2015 Accepting new patients
C-Health PC Past Accepting new patients
Blue Ridge Medical Management Corporation Past Accepting new patients

Locations

1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

3 Professional Park Dr
Ste 31
Johnson City, TN 37604
Phone (423) 232-6900

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

16000 Johnston Memorial Dr
Ste B
Abingdon, VA 24211

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

391 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-4406

24530 Falcon Place Blvd
Ste 100
Abingdon, VA 24211
Phone (276) 619-0075

1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111

495 E Main St
Lebanon, VA 24266
Phone (276) 889-3700

Networks

  • KY PPO
  • TN PPO C-SNP
  • KY PPO C-SNP
  • TN PPO
  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ballad Health HospiceAbingdon, VA, CCN 491542 Hospice W-2 Managing Employee Apr 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1003044694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 PETERS CREEK RD NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240172500",
            "telephone_number": "540-562-5703",
            "fax_number": "540-562-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 PETERS CREEK RD NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240172500",
            "telephone_number": "540-562-5703",
            "fax_number": "540-562-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LINDSAY",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "VA",
            "license": "0102203035",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0102203035",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102203035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.