Dermatology Practice of Roanoke PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0101252185 Issued in VA

Legal business name

DERMATOLOGY PRACTICE OF ROANOKE PC

Practice address

2000 Stephenson Ave
Roanoke, VA 24014-1664

Phone

(540) 427-7858

Fax

(540) 427-7878

NPI assigned

Jul 11, 2012

Last updated

Jul 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melanie Walter, MDNPI 1598939464

Title

Owner

Phone

(919) 323-5035

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melanie Rebecca Walter, M.D.

  • Dermatology Physician
  • Roanoke, VA
  • NPI 1598939464
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342742400000",
    "number": "1437414703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8734",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240140725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 STEPHENSON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141664",
            "telephone_number": "540-427-7858",
            "fax_number": "540-427-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY PRACTICE OF ROANOKE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-20",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-323-5035",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101252185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Depaul Family Services
• Serge E Depret-Guillaume, M.D.
• Mark Derbyshire, LCSW
• Dermatology Associates of Roanoke
• Dermatology Associates of Roanoke P C
• Matthew Robert Dernbach, MD
• Joanne B Derryberry, PT
• Jitendra S Desai, MD
• Varsha J. Desai, M.D.
• Grace G Desantis

• Dermatology Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.