NPIMap

Individual provider Active NPI

Mary-Ellen Mick, D.O.

  • Internal Medicine Physician
  • Blacksburg, VA
National Provider Identifier
1124339924
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0102203412 Issued in VA
Practice address
105 McDonald St
Blacksburg, VA 24060-3420
Phone
(540) 552-5545
Fax
(540) 552-5568
NPI assigned
Jun 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102203412 VA Primary
Internal Medicine Physician 207R00000X 0116022638 VA

Addresses

Primary practice location

105 McDonald St
Blacksburg, VA 24060-3420

Mailing address

105 McDonald St
Blacksburg, VA 24060-3420
Phone (540) 552-5545

Other identifiers 1

IdentifierTypeStateIssuer
1124339924MedicaidVA

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
I20130903000641 VA Practitioner - Internal Medicine 0143477216 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Practice addresses (Care Compare)

2900 Lamb Cir
Suite 250
Christiansburg, VA 24073-6345
Phone (540) 639-9071

Hospital & facility affiliations

  • Carilion Home Care Services Home health agency, Radford, VA, CCN 497260
  • Enhabit Home Health (Roanoke) Home health agency, Roanoke, VA, CCN 497608
  • Warm Hearth at Home Inc Home health agency, Christiansburg, VA, CCN 497733
  • Medi Home Health Agency Home health agency, Pulaski, VA, CCN 497584
  • Centerwell Home Health Home health agency, Roanoke, VA, CCN 497429
  • Carilion New River Valley Medical Center Hospital, Christiansburg, VA, CCN 490042
  • Lewisgale Hospital Montgomery Hospital, Blacksburg, VA, CCN 490110
  • Lewisgale Hospital Pulaski Hospital, Pulaski, VA, CCN 490116

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sowinski M.D PC CurrentSince May 1, 2026 Accepting new patients
Carilion Healthcare Corporation CurrentSince Aug 24, 2015 Accepting new patients
Blacksburg Wellness Center, LLC Internal Medicine CurrentSince May 1, 2026 Accepting new patients
Carilion Healthcare Corporation CurrentSince Aug 24, 2015 Accepting new patients

Locations

105 McDonald St
Blacksburg, VA 24060
Phone (540) 552-5545

2900 Lamb Cir
Ste 250
Christiansburg, VA 24073
Phone (540) 639-9071

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

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

Interoperability endpoints

  • Direct secure messaging: mmick16012@direct.carilionclinic.org

Organizations & group practices 4

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 9

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": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1124339924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MCDONALD ST",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240603420",
            "telephone_number": "540-552-5545",
            "fax_number": "540-552-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MCDONALD ST",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240603420",
            "telephone_number": "540-552-5545",
            "fax_number": "540-552-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICK",
        "first_name": "MARY-ELLEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102203412",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0116022638",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124339924",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.