Individual provider Active NPI

David Whittier O'Neil

  • Pediatrics Physician
  • Rocky Mount, VA
National Provider Identifier
1154909158
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101282101 Issued in VA
Practice address
490 S Main St
Rocky Mount, VA 24151-1769
Phone
(540) 484-0350
Fax
(540) 484-0337
NPI assigned
Mar 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 0101282101 VA Primary

Addresses

Primary practice location

490 S Main St
Rocky Mount, VA 24151-1769

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other practice location 1

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240801002686 VA Practitioner - Pediatric Medicine 4385045095 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101282101VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Jul 29, 2024 Accepting new patients
Carilion Medical Center CurrentSince Jul 29, 2024 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jul 29, 2024 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jul 29, 2024 Accepting new patients

Locations

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

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

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

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

490 S Main St
Rocky Mount, VA 24151
Phone (540) 483-4444

Interoperability endpoints

  • Direct secure messaging: doneil93428@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.

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1154909158",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 S MAIN ST",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "241511769",
            "telephone_number": "540-484-0350",
            "fax_number": "540-484-0337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1906 Belleview Ave SE",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240141838",
            "country_code": "US",
            "telephone_number": "540-981-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'NEIL",
        "first_name": "DAVID",
        "middle_name": "WHITTIER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101282101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, VA

Sources for this page

Verify at the official NPI Registry.