NPIMap

Organization Active NPI

Roanoke Valley Center for Sight LLC

  • Ambulatory Surgical Clinic/Center
  • Salem, VA
National Provider Identifier
1023005139
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
OH667 Issued in VA
Legal business name
ROANOKE VALLEY CENTER FOR SIGHT LLC
Practice address
438 W Main St
Salem, VA 24153-3610
Phone
(540) 855-3554
NPI assigned
Oct 4, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Authorized official

Name
Mrs. Staci E Runyon
Title
Managed Care Coordinator
Phone
(540) 855-3554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X OH667 VA Primary

Addresses

Primary practice location

438 W Main St
Salem, VA 24153-3610

Mailing address

PO Box 1789
Roanoke, VA 24008-1789
Phone (540) 378-5276

Other identifiers 1

IdentifierTypeStateIssuer
007603380MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040929000334 VA Part B Supplier - Clinic/Group Practice 0345219085 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wytheville, VA; Roanoke, VA; Martinsville, VA; Salem, VA
O20041103000952 VA Part B Supplier - Ambulatory Surgical Center 0345219085 Practice locations: Salem, VA; Roanoke, VA; Martinsville, VA
O20220421001150 VA Part B Supplier - Ambulatory Surgical Center 0345219085 Practice locations: Wytheville, VA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Roanoke Valley Center for Sight LLCCCN 49C0001021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Roanoke Valley Center F2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

433 Commonwealth Blvd E
Martinsville, VA 24112
Phone (276) 632-7207

2154 McVitty Rd SW
Ste 200
Roanoke, VA 24018
Phone (540) 378-5276

2154 McVitty Rd SW
Ste 101
Roanoke, VA 24018
Phone (540) 378-5276

2154 McVitty Rd SW
Roanoke, VA 24018

470 Lithia Rd
#2
Wytheville, VA 24382

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672358400000",
    "number": "1023005139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1789",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240081789",
            "telephone_number": "540-378-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 W MAIN ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533610",
            "telephone_number": "540-855-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROANOKE VALLEY CENTER FOR SIGHT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A",
        "authorized_official_last_name": "RUNYON",
        "authorized_official_first_name": "STACI",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGED CARE COORDINATOR",
        "authorized_official_telephone_number": "540-855-3554",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "VA",
            "license": "OH667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007603380",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.