NPIMap

Organization Active NPI

Lewis-Gale Physicians, LLC

  • Internal Medicine Physician
  • Roanoke, VA
National Provider Identifier
1316919210
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101033197 Issued in VA
Legal business name
LEWIS-GALE PHYSICIANS, LLC
Practice address
5303B Indian Grave Rd SW
Roanoke, VA 24014-6607
Phone
(540) 725-3060
Fax
(540) 772-4948
NPI assigned
Feb 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Otis Blackwood
Title
Practice Administrator
Phone
(540) 772-3672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 0101033197 VA Primary

Addresses

Primary practice location

5303B Indian Grave Rd SW
Roanoke, VA 24014-6607

Mailing address

5303B Indian Grave Rd SW
Roanoke, VA 24014-6607
Phone (540) 725-3060

Other names 1

  • Lewis-Gale Family Care - Clearbrook Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lewis-Gale Physicians LLC16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

5303 Indian Grave Rd
Roanoke, VA 24018
Phone (540) 725-3060

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316919210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5303B INDIAN GRAVE RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240146607",
            "telephone_number": "540-725-3060",
            "fax_number": "540-772-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5303B INDIAN GRAVE RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240146607",
            "telephone_number": "540-725-3060",
            "fax_number": "540-772-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS-GALE PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLACKWOOD",
        "authorized_official_first_name": "OTIS",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "540-772-3672"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101033197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lewis-Gale Family Care - Clearbrook",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 22, 2020; 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.