Individual provider Active NPI

Joseph Buckner Eddins III, PA

  • Physician Assistant
  • Roanoke, VA
National Provider Identifier
1285611269
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110005877 Issued in VA
Practice address
4035 Electric Rd Ste a
Roanoke, VA 24018-8449
Phone
(540) 772-8670
Fax
(540) 772-7901
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110005877 VA Primary

Addresses

Primary practice location

4035 Electric Rd Ste a
Roanoke, VA 24018-8449

Mailing address

213 S Jefferson St
Roanoke, VA 24011-1705
Phone (540) 224-5374

Other practice location 1

301 Andrews Ave
Fort Rucker, AL 36362-5333
Phone (334) 255-0302

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
I20171120001368 VA Practitioner - Physician Assistant 6709143118 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carilion Emergency Services IncGroup PAC ID 7012820889, 67 clinicians
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Practice addresses (Care Compare)

110 Houston St
Suite D
Lexington, VA 24450-2437
Phone (540) 591-9456

13205 Booker T Washington Hwy
Hardy, VA 24101-3947
Phone (540) 719-1815

1935 W Main St
Salem, VA 24153-3109
Phone (540) 387-0441

1955 W Main St
Salem, VA 24153-3109
Phone (540) 387-0441

215 Gilbert St
Blacksburg, VA 24060-3305
Phone (540) 266-6800

4035 Electric Rd
Roanoke, VA 24018-8449

434 Peppers Ferry NW Rd
Christiansburg, VA 24073-5780
Phone (540) 382-6000

46 Wesley Rd
Daleville, VA 24083-3082
Phone (540) 591-9440

6415 Peters Creek Rd
Roanoke, VA 24019-4021
Phone (703) 562-2110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110005877VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Nov 27, 2017 Accepting new patients
Carilion Emergency Services, Inc. CurrentSince Nov 27, 2017 Accepting new patients
Carilion Healthcare Corporation CurrentSince Nov 27, 2017 Accepting new patients

Locations

434 Peppers Fry Rd NW
Christiansburg, VA 24073
Phone (540) 382-6000

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

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

4035 Electric Rd
Ste A
Roanoke, VA 24018
Phone (540) 772-8670

1935 W Main St
Salem, VA 24153
Phone (540) 302-0190

Interoperability endpoints

  • Direct secure messaging: jeddins97060@direct.carilionclinic.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1285611269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111705",
            "telephone_number": "540-224-5374",
            "fax_number": "540-224-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 ELECTRIC RD STE A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240188449",
            "telephone_number": "540-772-8670",
            "fax_number": "540-772-7901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Andrews Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Rucker",
            "state": "AL",
            "postal_code": "363625333",
            "country_code": "US",
            "telephone_number": "334-255-0302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDDINS",
        "first_name": "JOSEPH",
        "middle_name": "BUCKNER",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110005877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.