Active NPI
John W. Pendleton, M.D.
- Rheumatology Physician
- Roanoke, VA
National Provider Identifier
1275516452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 0101033045
- Practice address
- 3 Rivers Circle
Roanoke, VA 24016 - Phone
- (540) 224-5170
- Fax
- (540) 983-8229
- NPI assigned
- Nov 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 0101033045 | VA | Primary |
Addresses
Primary practice location
3 Rivers Circle
Roanoke, VA 24016
Mailing address
3 Rivers Circle
Roanoke, VA 24016
Phone (540) 224-5170
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5806216 | Medicaid | VA | |
| 5886601 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101033045 | VA | MD | Rheumatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313020800000",
"number": "1275516452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 RIVERS CIRCLE",
"city": "ROANOKE",
"state": "VA",
"postal_code": "24016",
"telephone_number": "540-224-5170",
"fax_number": "540-983-8229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 RIVERS CIRCLE",
"city": "ROANOKE",
"state": "VA",
"postal_code": "24016",
"telephone_number": "540-224-5170",
"fax_number": "540-983-8229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENDLETON",
"first_name": "JOHN",
"middle_name": "W.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-22",
"last_updated": "2011-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "VA",
"license": "0101033045",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5806216",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5886601",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.