Active NPI
Robert B Mountcastle, M.D.
- Internal Medicine Physician
- Roanoke, VA
National Provider Identifier
1124065701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0101036578
- Practice address
- 4461 Starkey Road
Suite 201
Roanoke, VA 24018 - Phone
- (540) 345-4946
- Fax
- (540) 343-7693
- NPI assigned
- Jun 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101036578 | VA | Primary |
Addresses
Primary practice location
4461 Starkey Road
Suite 201
Roanoke, VA 24018
Mailing address
4461 Starkey Road
Suite 201
Roanoke, VA 24018
Phone (540) 345-4946
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 263823 | Other | VA | ANTHEM |
| 1124065701 | Medicaid | VA | |
| 110127675 | Other | VA | RAILROAD MEDICARE |
| 5102431 | Other | VA | CIGNA |
| 288083 | Other | VA | SOUTHERN HEALTH |
| 4293157 | Other | VA | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101036578 | VA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301961600000",
"number": "1124065701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4461 STARKEY ROAD",
"address_2": "SUITE 201",
"city": "ROANOKE",
"state": "VA",
"postal_code": "24018",
"telephone_number": "540-345-4946",
"fax_number": "540-343-7693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4461 STARKEY ROAD",
"address_2": "SUITE 201",
"city": "ROANOKE",
"state": "VA",
"postal_code": "24018",
"telephone_number": "540-345-4946",
"fax_number": "540-343-7693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUNTCASTLE",
"first_name": "ROBERT",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-01",
"last_updated": "2011-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101036578",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "263823",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124065701",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110127675",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "5102431",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHERN HEALTH",
"identifier": "288083",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4293157",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.