Organization Active NPI

Karl C. Saliba, O.D., PC

  • Optometrist
  • Roanoke, VA
National Provider Identifier
1164674289
Registry record updated Nov 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000122 Issued in VA
Legal business name
KARL C. SALIBA, O.D., PC
Practice address
2222 Electric Road, S.W.
Suite 201
Roanoke, VA 24018-2300
Phone
(540) 774-8007
Fax
(540) 774-4530
NPI assigned
Oct 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2009

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

Authorized official

Name
Karl C Saliba, ODNPI 1891723888
Title
Owner
Phone
(540) 774-8007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 0618000122 VA Primary

Addresses

Primary practice location

2222 Electric Road, S.W.
Suite 201
Roanoke, VA 24018-2300

Mailing address

2222 Electric Road, S.W.
Suite 201
Roanoke, VA 24018-2300
Phone (540) 774-8007

Other identifiers 1

IdentifierTypeStateIssuer
9205047MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090528000070 VA Part B Supplier - Clinic/Group Practice 8426107228 Receives reassigned benefits from 1 practitioner
Practice locations: Floyd, VA; Roanoke, VA

National Provider Directory

National Provider Directory

Locations

112B W Main St
Floyd, VA 24091
Phone (540) 745-3100

2222 Electric Rd
Ste 201
Roanoke, VA 24018
Phone (540) 774-8007

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257206400000",
    "number": "1164674289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 ELECTRIC ROAD, S.W.",
            "address_2": "SUITE 201",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240182300",
            "telephone_number": "540-774-8007",
            "fax_number": "540-774-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 ELECTRIC ROAD, S.W.",
            "address_2": "SUITE 201",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240182300",
            "telephone_number": "540-774-8007",
            "fax_number": "540-774-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KARL C. SALIBA, O.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2009-11-03",
        "status": "A",
        "authorized_official_last_name": "SALIBA",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-774-8007",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9205047",
            "state": "VA"
        }
    ],
    "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 Nov 3, 2009; 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.