Hannah Seldomridge, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110007309 Issued in VA

Practice address

4633 Brambleton Ave Ste 100
Roanoke, VA 24018-3410

Phone

(540) 968-7368

Fax

(844) 212-0402

NPI assigned

May 30, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Hannah Bacon Former name

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Roanoke Valley ENT and Allergy PCGroup PAC ID 6305199324, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26460/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/AIDFBD/Endpoint/AIDFBD

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.

• Roanoke Valley ENT & Allergy PC

  • Otolaryngology Physician
  • Roanoke, VA
  • NPI 1174005417
  Medicare reassignment Care Compare group
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC

  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD

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

{
    "created_epoch": "1590796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1043834633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8310",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240140310",
            "telephone_number": "540-345-3556",
            "fax_number": "540-342-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4633 BRAMBLETON AVE STE 100",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183410",
            "telephone_number": "540-968-7368",
            "fax_number": "844-212-0402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7432 Little River Tpke",
            "address_purpose": "LOCATION",
            "city": "Annandale",
            "state": "VA",
            "postal_code": "220033013",
            "country_code": "US",
            "telephone_number": "703-658-7060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2154 McVitty Rd SW Fl 2",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240181642",
            "country_code": "US",
            "telephone_number": "540-968-7368",
            "fax_number": "540-655-1888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELDOMRIDGE",
        "first_name": "HANNAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-30",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110007309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "BACON",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katelyn Ann Seay, FNP
• Second to Nature
• Donald George Seibert, MD
• Irene Pace Seidman, RPH
• Jenna Marie Selander, DO
• Bryant Self, D.O.
• Lauren S Self, D.O.
• Bruce Sellars, PSY.D.
• Melissia C Selwyn, LPTA
• Semtner & Semtner, DDS, Inc.

• Medical Physician Assistant in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.