Active NPI
Nicholas Rider, D.O.
- Allergy & Immunology Physician
- Roanoke, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 0102207181
- Practice address
- 4348 Electric Rd
Roanoke, VA 24018-0720 - Phone
- (540) 769-0950
- NPI assigned
- Apr 19, 2007
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | OS014332 | PA | |
| Internal Medicine Physician | 207R00000X | 0102207181 | VA | |
| Pediatrics Physician | 208000000X | 0102207181 | VA | |
| Allergy & Immunology Physician | 207K00000X | 0102207181 | VA | Primary |
Addresses
Primary practice location
4348 Electric Rd
Roanoke, VA 24018-0720
Mailing address
213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Other practice location 1
220 Wilson Street
Suite 200
Carlisle, PA 17013-3697
Phone (717) 243-7540
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Allergy/Immunology
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925
2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128
4348 Electric Rd
Roanoke, VA 24018-0720
Phone (540) 769-0976
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102207181 | VA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carilion Medical Center | Current | Accepting new patients | |
| Carilion Medical Center | Current | Accepting new patients | |
| Privia Medical Group, LLC | Current | Accepting new patients | |
| Privia Medical Group, LLC | Allergy & Immunology | Current | Accepting new patients |
| Carilion Medical Center | Past | Accepting new patients |
Locations
8644 Sudley Rd
#220
Manassas, VA 20110
2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128
213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353
4348 Electric Rd
Roanoke, VA 24018
Phone (540) 769-0600
Interoperability endpoints
- nrider176807@direct.carilionclinic.org
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Roanoke, VA
- NPI 1730123472
-
- Internal Medicine Physician
- Arlington, VA
- NPI 1013042480
Allergy & Immunology
-
- Durable Medical Equipment & Medical Supplies
- Hardy, VA
- NPI 1073324810
-
- Pain Medicine (Psychiatry & Neurology) Physician
- Rockville, MD
- NPI 1811715436
-
- General Acute Care Hospital
- Roanoke, VA
- NPI 1033102942
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Roanoke, VA
- NPI 1033102942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707436800000",
"number": "1295952588",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4348 ELECTRIC RD",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240180720",
"telephone_number": "540-769-0950"
}
],
"practiceLocations": [
{
"address_1": "220 Wilson Street",
"address_2": "Suite 200",
"address_purpose": "LOCATION",
"city": "Carlisle",
"state": "PA",
"postal_code": "170133697",
"country_code": "US",
"telephone_number": "717-243-7540",
"fax_number": "717-243-9968",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RIDER",
"first_name": "NICHOLAS",
"name_prefix": "Mr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2024-02-09",
"certification_date": "2024-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "PA",
"license": "OS014332",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0102207181",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0102207181",
"primary": false
},
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "VA",
"license": "0102207181",
"primary": true
}
],
"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 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.