Individual provider Active NPI

Christian Brody Van Doren, DO

  • Physical Medicine & Rehabilitation Physician
  • Roanoke, VA
National Provider Identifier
1104441013
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0102208220 Issued in VA
Practice address
2331 Franklin Rd SW
Roanoke, VA 24014-1111
Phone
(540) 224-5170
NPI assigned
Jun 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2021019753 MO
Internal Medicine Physician 207R00000X 2020016721 MO
Physical Medicine & Rehabilitation Physician 208100000X 0102208220 VA Primary

Addresses

Primary practice location

2331 Franklin Rd SW
Roanoke, VA 24014-1111

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other practice location 1

315 W Business Loop 70
Columbia, MO 65203-3248
Phone (573) 882-0406

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240814000435 VA Practitioner - Physical Medicine and Rehabilitation 2961825633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Kansas City College of Medicine and Surgery, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

101 Elm Ave
Roanoke, VA 24013-2222
Phone (540) 224-4380

101 Elm Ave SE
FL 3
Roanoke, VA 24013-2222
Phone (540) 224-6780

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

2331 Franklin Rd SW
Roanoke, VA 24014-1111
Phone (540) 224-5170

Hospital & facility affiliations

  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Aug 12, 2024 Accepting new patients
Carilion Medical Center CurrentSince Aug 12, 2024 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

2331 Franklin Rd SW
Roanoke, VA 24014
Phone (540) 725-1226

101 Elm Ave SE
Roanoke, VA 24013
Phone (540) 985-8000

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

Interoperability endpoints

  • Direct secure messaging: cvandoren168673@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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1104441013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141111",
            "telephone_number": "540-224-5170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W Business Loop 70",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652033248",
            "country_code": "US",
            "telephone_number": "573-882-0406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DOREN",
        "first_name": "CHRISTIAN",
        "middle_name": "BRODY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-16",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2021019753",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2020016721",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0102208220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.