Active NPI
Patricia Delong
- Pharmacist
- Roanoke, VA
National Provider Identifier
1275924912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202011375
- Practice address
- 4049 Brambleton Ave
Roanoke, VA 24018-3426 - Phone
- (540) 725-1546
- NPI assigned
- Feb 17, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202011375 | VA | Primary |
| Pharmacist | 183500000X | 16601 | NC |
Addresses
Primary practice location
4049 Brambleton Ave
Roanoke, VA 24018-3426
Mailing address
1715 Devon Rd SW
Roanoke, VA 24015-2621
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16601 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| 0202011375 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- Roanoke, VA
- NPI 1003821059
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424131200000",
"number": "1275924912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1715 DEVON RD SW",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240152621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4049 BRAMBLETON AVE",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240183426",
"telephone_number": "540-725-1546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELONG",
"first_name": "PATRICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-17",
"last_updated": "2015-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202011375",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "16601",
"primary": false
}
],
"identifiers": [],
"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 Feb 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.