NPIMap

Individual provider Active NPI

Randall Rhea, MD

  • Family Medicine Physician
  • Vinton, VA
National Provider Identifier
1073586970
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101-034637 Issued in VA
Practice address
415 S Pollard St
Vinton, VA 24179-2502
Phone
(540) 983-6700
NPI assigned
Feb 10, 2006
Last updated
Aug 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101-034637 VA Primary

Addresses

Primary practice location

415 S Pollard St
Vinton, VA 24179-2502

Mailing address

1627 Center Hill Dr SW
Roanoke, VA 24015-3629

Other identifiers 3

IdentifierTypeStateIssuer
005623944MedicaidVA
005638127MedicaidVA
5637864MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081208000531 VA Practitioner - Family Practice 2769388685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Tennessee, HSC, College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Practice addresses (Care Compare)

415 S Pollard St
Carilion Family Medicine Parkway Physicians
Vinton, VA 24179-2502
Phone (540) 983-6700

6415 Peters Creek Rd
Roanoke, VA 24019-4021
Phone (703) 562-2110

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101-034637VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Oct 1, 1994 Accepting new patients
Carilion Healthcare Corporation CurrentSince Oct 1, 1994 Accepting new patients
Bradley Free Clinic of Roanoke Valley Past Accepting new patients

Locations

1030 S Jefferson St
Ste 110
Roanoke, VA 24016
Phone (540) 345-5024

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

37 Laymantown Rd
Troutville, VA 24175
Phone (540) 977-1436

415 S Pollard St
Vinton, VA 24179
Phone (540) 938-6700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18289/brand/1/csg/1/fhir/r4
  • Direct secure messaging: randall.rhea.1@18289.direct.athenahealth.com
  • Direct secure messaging: rrhea19422@direct.carilionclinic.org

Organizations & group practices 3

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

Hospital & facility affiliations 4

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1073586970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 CENTER HILL DR SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240153629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S POLLARD ST",
            "city": "VINTON",
            "state": "VA",
            "postal_code": "241792502",
            "telephone_number": "540-983-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHEA",
        "first_name": "RANDALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101-034637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005623944",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005638127",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5637864",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vinton, VA

Sources for this page

Verify at the official NPI Registry.