Organization Active NPI

Aspen Physical Medicine, LLC

  • Physical Medicine & Rehabilitation Physician
  • Roanoke, VA
National Provider Identifier
1164086625
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ASPEN PHYSICAL MEDICINE, LLC
Practice address
2110 Carolina Ave SW FL 2
Roanoke, VA 24014-1742
Phone
(540) 492-4222
Fax
(540) 343-0056
NPI assigned
Apr 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Authorized official

Name
Jennifer Elizabeth Walker, DC
Title
President
Phone
(540) 492-4222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

2110 Carolina Ave SW FL 2
Roanoke, VA 24014-1742

Mailing address

2110 Carolina Ave SW FL 2
Roanoke, VA 24014-1742
Phone (540) 492-4222

National Provider Directory

National Provider Directory

Locations

2110 Carolina Ave SW
Fl 2
Roanoke, VA 24014
Phone 5403454230412

NPI Registry JSON

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556582400000",
    "number": "1164086625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 CAROLINA AVE SW FL 2",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141742",
            "telephone_number": "540-492-4222",
            "fax_number": "540-343-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 CAROLINA AVE SW FL 2",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141742",
            "telephone_number": "540-492-4222",
            "fax_number": "540-343-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPEN PHYSICAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-04-30",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-492-4222",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "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 Apr 30, 2019; 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.