NPIMap

Individual provider Active NPI

Amy W Doolan, D.O.

  • Family Medicine Physician
  • Roanoke, VA
National Provider Identifier
1265630248
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102202640 Issued in VA
Practice address
213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone
(540) 224-5352
NPI assigned
Jul 11, 2007
Last updated
Sep 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS021490 PA
Family Medicine Physician 207Q00000X 0102202640 VA Primary

Addresses

Primary practice location

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5352

Other practice location 1

530 Centre St
Ashland, PA 17921-1330
Phone (570) 645-1670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101206000607 VA Practitioner - Family Practice 1456548221 Reassigns benefits to 2 organizations
I20210831003177 PA Practitioner - Family Practice 1456548221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Practice addresses (Care Compare)

415 S Pollard St
Carilion Family Medicine Parkway Physicians
Vinton, VA 24179-2502
Phone (540) 983-6700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group Inc Family Medicine CurrentSince Oct 18, 2021 Accepting new patients
Carilion Healthcare Corporation CurrentSince Nov 6, 2023 Accepting new patients
Carilion Healthcare Corporation CurrentSince Nov 6, 2023 Accepting new patients
St. Luke's Physician Group, Inc. Family Medicine Current Accepting new patients
St Luke's Physician Group Inc Family Medicine CurrentSince Oct 18, 2021 Accepting new patients
Carilion Franklin Memorial Hospital Past Accepting new patients

Locations

530 W Center St
Ashland, PA 17921
Phone (570) 645-1670

4311 Easton Ave
Bethlehem, PA 18020
Phone (610) 954-3600

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

1314 Peters Creek Rd NW
Roanoke, VA 24017
Phone (540) 427-9200

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

2145 Mount Pleasant Blvd SE
Roanoke, VA 24014
Phone (540) 427-3020

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

415 S Pollard St
Vinton, VA 24179
Phone (540) 938-6700

Interoperability endpoints

  • Direct secure messaging: adoolan5338@direct.carilionclinic.org
  • Direct secure messaging: amy.doolan@slpg.direct-sluhn.org

Organizations & group practices 7

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 7

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": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1265630248",
    "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": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 Centre St",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "PA",
            "postal_code": "179211330",
            "country_code": "US",
            "telephone_number": "570-645-1670",
            "fax_number": "866-230-8090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOOLAN",
        "first_name": "AMY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS021490",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102202640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.