Individual provider Active NPI

Prasanti Pinnamaraju

  • Family Nurse Practitioner
  • Roanoke, VA
National Provider Identifier
1225638026
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024180126 Issued in VA
Practice address
5324 Fox Ridge Rd
Roanoke, VA 24018-8754
Phone
(612) 245-8710
NPI assigned
Oct 29, 2020
Last updated
Oct 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024180126 VA Primary

Addresses

Primary practice location

5324 Fox Ridge Rd
Roanoke, VA 24018-8754

Mailing address

PO Box 20844
Roanoke, VA 24018-0085
Phone (612) 245-8710

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210415000120 VA Practitioner - Nurse Practitioner 9537577390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Practice addresses (Care Compare)

3707 Brambleton Ave SW
2 Carilion Family Medicine Brambleton
Roanoke, VA 24018-3658
Phone (540) 725-7800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Jul 31, 2023 Accepting new patients
Carilion Healthcare Corporation CurrentSince Nov 21, 2021 Accepting new patients
Carilion Healthcare Corporation CurrentSince Nov 21, 2021 Accepting new patients
Carilion Medical Center CurrentSince Jul 31, 2023 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

3707 Brambleton Ave
Ste 2
Roanoke, VA 24018
Phone (540) 725-7800

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

1945 Roanoke Blvd
Salem, VA 24153
Phone (540) 345-3094

Interoperability endpoints

  • Direct secure messaging: ppinnamaraju41963@direct.carilionclinic.org

Organizations & group practices 4

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 1

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": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1225638026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20844",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180085",
            "telephone_number": "612-245-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5324 FOX RIDGE RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240188754",
            "telephone_number": "612-245-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINNAMARAJU",
        "first_name": "PRASANTI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024180126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.