NPIMap

Organization Active NPI

Carilion Medical Center

  • Psychiatric Hospital Unit
  • Roanoke, VA
National Provider Identifier
1154307155
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
CARILION MEDICAL CENTER
Practice address
2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone
(540) 224-5512
Fax
(540) 224-5458
NPI assigned
Dec 21, 2005
Last updated
Feb 27, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CARILION MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Authorized official

Name
Eleanor Altman Prescott
Title
Director of Payer Contract Admin.
Phone
(504) 224-5379

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X NU Primary

Addresses

Primary practice location

2017 Jefferson St SW
Roanoke, VA 24014-2419

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5715

Other names 2

  • Carilion Roanoke Memorial Hospital - Psychiatric Unit Other name
  • Carilion Roanoke Memorial Hospital-Psych Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071214000469 VA Part A Provider - Hospital 9830096585 Practice locations: Roanoke, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154307155. Details of each certification follow.

Hospital certification: CCN 49S024

Legal name
CARILION MEDICAL CENTER
Doing business as
CARILION ROANOKE COMMUNITY HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
May 8, 1989 in VA
Enrollment address
2017 S Jefferson St
Roanoke, VA 24014-2419
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Carilion Professional B19 organizations share this tax ID, including this one
Part of
Carilion Professional B

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

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

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
George Robert Vaughan Individual Corporate DirectorExecutive Vice President Jan 1, 2010
Ann Hoff Individual Corporate Officer Oct 1, 2021
Isabel R Thornton Individual Corporate Officer Oct 1, 2021
Michael S Nussbaum Individual Corporate Officer Oct 1, 2021
Paul a Haskins Individual Corporate Officer Oct 1, 2021
Eleanor Prescott Individual W-2 Managing EmployeeAd; Oct 14, 2025
Michael Abbott Individual W-2 Managing Employee Oct 6, 2025
Joshua Hartle Individual W-2 Managing Employee Oct 14, 2025
Donald B Halliwill Individual Corporate DirectorExecutive Vice President Apr 1, 2013
Jamie Greenawalt Individual Corporate Officer Oct 1, 2023
Carilion Clinic Organization, Roanoke, VA Corporation 5% Or Greater Direct Ownership Interest Nov 2, 2010
Daniel R Tershak Individual Corporate OfficerChief of Medical Staff Oct 1, 2023
Lee Learman Individual Corporate Officer Oct 1, 2021
Janet Frantz Individual Corporate Officer Oct 1, 2021
Kimberly Reynolds Individual Operational/Managerial Control May 22, 2023
Kianna Price Marshall Individual Corporate Officer Oct 1, 2021

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 31

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772150400000",
    "number": "1154307155",
    "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",
            "telephone_number": "540-224-5715",
            "fax_number": "540-224-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 JEFFERSON ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142419",
            "telephone_number": "540-224-5512",
            "fax_number": "540-224-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARILION MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARILION MEDICAL CENTER",
        "enumeration_date": "2005-12-21",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A",
        "authorized_official_last_name": "PRESCOTT",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_middle_name": "ALTMAN",
        "authorized_official_title_or_position": "DIRECTOR OF PAYER CONTRACT ADMIN.",
        "authorized_official_telephone_number": "504-224-5379"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carilion Roanoke Memorial Hospital - Psychiatric Unit",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Carilion Roanoke Memorial Hospital-Psych",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.