NPIMap

Organization Active NPI

Dermatology Associates of Roanoke

  • Specialist
  • Roanoke, VA
National Provider Identifier
1134536832
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101049323 Issued in VA
Legal business name
DERMATOLOGY ASSOCIATES OF ROANOKE
Practice address
1215 3Rd St SW
Roanoke, VA 24016-4611
Phone
(540) 345-6010
Fax
(540) 345-5446
NPI assigned
Jul 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Authorized official

Name
Susie R Craig
Title
Office Manager
Phone
(540) 345-6010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 0101049323 VA Primary

Addresses

Primary practice location

1215 3Rd St SW
Roanoke, VA 24016-4611

Mailing address

1215 3Rd St SW
Roanoke, VA 24016-4611
Phone (540) 345-6010

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405382400000",
    "number": "1134536832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 3RD ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164611",
            "telephone_number": "540-345-6010",
            "fax_number": "540-345-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 3RD ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164611",
            "telephone_number": "540-345-6010",
            "fax_number": "540-345-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF ROANOKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-15",
        "last_updated": "2014-07-15",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "540-345-6010"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101049323",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.