NPIMap

Individual provider Active NPI

Jamie Lynn Carlo-Demovich, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Galax, VA
National Provider Identifier
1184703266
Registry record updated Jun 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
0101245432 Issued in VA
Practice address
200 Hospital Dr
Galax, VA 24333-2227
Phone
(276) 236-1690
NPI assigned
Nov 2, 2006
Last updated
Jun 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 0101245432 VA Primary

Addresses

Primary practice location

200 Hospital Dr
Galax, VA 24333-2227

Mailing address

PO Box 21569
Roanoke, VA 24018-0568

Other identifiers 3

IdentifierTypeStateIssuer
153C1OtherNCBCBS OF NC
5911785MedicaidNC
1184703266MedicaidVA

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
I20090618000548 VA Practitioner - Pathology 4082764766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Miami, LM Miller School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 W Ridge Rd
Wytheville, VA 24382-1044
Phone (276) 228-0200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.42 of 100Reported as individual
Quality
84.85
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates of Southwestern Virginia Inc Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2009 Accepting new patients
DLP Twin County Regional Healthcare LLC Current Accepting new patients

Locations

6100 Waterford District Dr
Ste 450
Miami, FL 33126

200 Hospital Dr
Galax, VA 24333
Phone (276) 236-6011

600 W Ridge Rd
Wytheville, VA 24382
Phone (276) 228-0200

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.

Hospital & facility affiliations 9

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497571200000",
    "number": "1184703266",
    "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": "200 HOSPITAL DR",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332227",
            "telephone_number": "276-236-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLO-DEMOVICH",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2017-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101245432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "153C1",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5911785",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184703266",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galax, VA

Sources for this page

Verify at the official NPI Registry.