Active NPI
Luke Ennis
- Hospitalist Physician
- Roanoke, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 2021-01409
- Practice address
- 3 Riverside Cir
Roanoke, VA 24016-4955 - Phone
- (540) 224-5170
- Fax
- (540) 983-8229
- NPI assigned
- Apr 6, 2018
- Last updated
- May 4, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Hospitalist Physician | 208M00000X | 2021-01409 | NC | Primary |
Addresses
Primary practice location
3 Riverside Cir
Roanoke, VA 24016-4955
Mailing address
213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5352
Other practice location 1
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000
Other practice location 2
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-8383
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Campbell Univ School of Osteopathic Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3 Riverside Cir
Roanoke, VA 24016-4955
Phone (540) 224-5170
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carilion Medical Center | Current | Accepting new patients | |
| Carilion Medical Center | Current | Accepting new patients |
Locations
1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222
2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128
213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353
3 Riverside Cir
Roanoke, VA 24016
Interoperability endpoints
- lennis101416@direct.carilionclinic.org
- luke.ennis.1@18289.direct.athenahealth.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Roanoke, VA
- NPI 1730123472
-
dba Carilion Clinic - DME - Westlake
- Durable Medical Equipment & Medical Supplies
- Hardy, VA
- NPI 1073324810
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Carilion Roanoke Memorial Hospital
- General Acute Care Hospital
- Roanoke, VA
- NPI 1033102942
-
dba Carilion Clinic Home Health
- Home Health Agency
- Roanoke, VA
- NPI 1073506002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683158400000",
"number": "1184121279",
"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": "540-224-5352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 RIVERSIDE CIR",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240164955",
"telephone_number": "540-224-5170",
"fax_number": "540-983-8229"
}
],
"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"
},
{
"address_1": "3333 Silas Creek Pkwy",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271033013",
"country_code": "US",
"telephone_number": "336-718-8383",
"fax_number": "336-718-9622",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ENNIS",
"first_name": "LUKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-06",
"last_updated": "2023-05-04",
"certification_date": "2023-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NC",
"license": "2021-01409",
"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 May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.