NPIMap

Organization Active NPI

Roanoke Valley Center for Sight, LLC

  • Certified Registered Nurse Anesthetist
  • Salem, VA
National Provider Identifier
1245502913
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
ROANOKE VALLEY CENTER FOR SIGHT, LLC
Practice address
438 W Main St
Salem, VA 24153-3610
Phone
(540) 378-5276
Fax
(540) 342-4373
NPI assigned
Jan 27, 2012
Last updated
Sep 30, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
ROANOKE VALLEY CENTER FOR SIGHT, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Authorized official

Name
Mrs. Staci Elaine Runyon
Title
Managed Care Coordinator
Phone
(540) 855-5139

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X OH667 VA
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

438 W Main St
Salem, VA 24153-3610

Mailing address

PO Box 1789
Roanoke, VA 24008-1789
Phone (540) 855-5139

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040929000334 VA Part B Supplier - Clinic/Group Practice 0345219085 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
Practice locations: Wytheville, VA; Roanoke, VA; Martinsville, VA; Salem, VA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Roanoke Valley Center2 organizations share this tax ID, including this one
Part of
Roanoke Valley Center

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569801600000",
    "number": "1245502913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1789",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240081789",
            "telephone_number": "540-855-5139",
            "fax_number": "540-342-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 W MAIN ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533610",
            "telephone_number": "540-378-5276",
            "fax_number": "540-342-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROANOKE VALLEY CENTER FOR SIGHT, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROANOKE VALLEY CENTER FOR SIGHT, LLC",
        "enumeration_date": "2012-01-27",
        "last_updated": "2019-09-30",
        "status": "A",
        "authorized_official_last_name": "RUNYON",
        "authorized_official_first_name": "STACI",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "MANAGED CARE COORDINATOR",
        "authorized_official_telephone_number": "540-855-5139",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "VA",
            "license": "OH667",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.