Individual provider Active NPI

Michael Sisk, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Roanoke, VA
National Provider Identifier
1306898713
Registry record updated Sep 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
0101021297 Issued in VA
Practice address
4431 Starkey Road
Roanoke, VA 24018-0612
Phone
(540) 342-0211
Fax
(540) 344-5543
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 0101021297 VA Primary

Addresses

Primary practice location

4431 Starkey Road
Roanoke, VA 24018-0612

Mailing address

4431 Starkey Road
Roanoke, VA 24018-0612
Phone (540) 342-0211

Other identifiers 1

IdentifierTypeStateIssuer
006156908MedicaidVA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roanoke Neurological Associates 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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1306898713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4431 STARKEY ROAD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180612",
            "telephone_number": "540-342-0211",
            "fax_number": "540-344-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4431 STARKEY ROAD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180612",
            "telephone_number": "540-342-0211",
            "fax_number": "540-344-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISK",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "VA",
            "license": "0101021297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006156908",
            "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 Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.