NPIMap

Organization Active NPI

Roanoke Valley Health Services, Inc

  • Pulmonary Disease Physician
  • Roanoke Rapids, NC
National Provider Identifier
1154774032
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
ROANOKE VALLEY HEALTH SERVICES, INC
Practice address
210 Smith Church Rd Ste B
Roanoke Rapids, NC 27870-4942
Phone
(252) 535-1082
NPI assigned
Jul 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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

Authorized official

Name
Sherry Jensen
Title
VP, Finance
Phone
(252) 535-8005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

210 Smith Church Rd Ste B
Roanoke Rapids, NC 27870-4942

Mailing address

240 Smith Church Rd
Suite a
Roanoke Rapids, NC 27870-4903
Phone (252) 535-1082

Other names 1

  • Roanoke Valley Pulmonology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050119001033 NC Part B Supplier - Clinic/Group Practice 4587573159 Receives reassigned benefits from 9 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, NC; Knightdale, NC; Roanoke Rapids, NC

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468540800000",
    "number": "1154774032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 SMITH CHURCH RD",
            "address_2": "SUITE A",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704903",
            "telephone_number": "252-535-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SMITH CHURCH RD STE B",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704942",
            "telephone_number": "252-535-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROANOKE VALLEY HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-15",
        "last_updated": "2016-07-15",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "VP, FINANCE",
        "authorized_official_telephone_number": "252-535-8005"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roanoke Valley Pulmonology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke Rapids, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.