Individual provider Active NPI

Vydia Permashwar, MD

  • Pediatrics Physician
  • Rocky Mount, VA
National Provider Identifier
1336245471
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101229805 Issued in VA
Practice address
681 S Main St
Rocky Mount, VA 24151-1750
Phone
(540) 483-2849
NPI assigned
Sep 16, 2006
Last updated
Dec 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101229805 VA Primary

Addresses

Primary practice location

681 S Main St
Rocky Mount, VA 24151-1750

Mailing address

4313 Fox Croft Cir
Roanoke, VA 24018-8945
Phone (540) 776-1821

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vpermashwar40190@direct.carilionclinic.org Direct

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171206002252 VA Practitioner - Pediatric Medicine 0244597888 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101229805VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Oct 3, 2017 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jan 31, 2021 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jan 31, 2021 Accepting new patients
Carilion Medical Center CurrentSince Oct 3, 2017 Accepting new patients
Carilion Medical Center Past Accepting new patients
Rene N. Vamenta, M.D. Pediatrics Past Accepting new patients

Locations

60 Market Center Way
Daleville, VA 24083
Phone (540) 992-1251

1030 S Jefferson St
Ste 106
Roanoke, VA 24016
Phone (540) 343-4092

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

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

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

Interoperability endpoints

  • Direct secure messaging: vpermashwar40190@direct.carilionclinic.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1336245471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4313 FOX CROFT CIR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240188945",
            "telephone_number": "540-776-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 S MAIN ST",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "241511750",
            "telephone_number": "540-483-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERMASHWAR",
        "first_name": "VYDIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101229805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vpermashwar40190@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "vpermashwar40190@direct.carilionclinic.org",
            "address_1": "681 S Main St",
            "city": "Rocky Mount",
            "state": "VA",
            "country_code": "US",
            "postal_code": "241511750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rocky Mount, VA

Sources for this page

Verify at the official NPI Registry.