NPIMap

Individual provider Active NPI

Douglas James Grider, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Roanoke, VA
National Provider Identifier
1184684581
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
0101247057 Issued in VA
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone
(540) 981-7271
NPI assigned
Mar 28, 2006
Last updated
Mar 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 0101247057 VA Primary
Dermatopathology Physician 207ND0900X 0101247057 VA

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

PO Box 21569
Roanoke, VA 24018-0568

Other identifiers 3

IdentifierTypeStateIssuer
1184684581MedicaidVA
3810017221MedicaidWV
P00836588OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100726000543 VA Practitioner - PathologyPractitioner - Dermatology 2567594658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PathologyAlso: Dermatology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dominion Pathology Associates PCGroup PAC ID 8628031630, 9 clinicians

Practice addresses (Care Compare)

1 Riverside Cir
Suite 105
Roanoke, VA 24016-4961
Phone (540) 581-0148

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.57 of 100Reported as group
Quality
73.14
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Pathology Associates PC Anatomic Pathology & Clinical Pathology CurrentSince Jun 15, 2010 Accepting new patients

Locations

1 Health Cir
Lexington, VA 24450
Phone (540) 458-3300

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

Organizations & group practices 1

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1184684581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21569",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIDER",
        "first_name": "DOUGLAS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101247057",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "VA",
            "license": "0101247057",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184684581",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810017221",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00836588",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.