Lori Dudley, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810-003042 Issued in VA

Practice address

4348 Electric Rd
Roanoke, VA 24018-0720

Phone

(540) 769-0976

Fax

(540) 857-5385

NPI assigned

Feb 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Carilion Medical Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1730123472
  Medicare reassignment NPD
• Carilion Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Hardy, VA
  • NPI 1073324810
  NPD

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1477529972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 S JEFFERSON ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164404",
            "telephone_number": "540-853-0900",
            "fax_number": "540-853-0511"
        },
        {
            "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": "540-769-0976",
            "fax_number": "540-857-5385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Psc 41",
            "address_2": "48 MDG/MDOS Unit 5210 Box 230",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "094649998",
            "country_code": "US",
            "telephone_number": "163-852-3308",
            "fax_number": "163-852-6600",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "LORI",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810-003042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010047668",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010194644",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010194679",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7712910",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010194652",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010077656",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010077672",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ldudley15142@direct.carilionclinic.org",
            "affiliation": "N",
            "endpointDescription": "ldudley15142@direct.carilionclinic.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "902 S Jefferson St",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "24016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin F Ducey, MD
• Francis Joseph Duckwall, M.D.
• Elizabeth H. Duckworth, M.D.
• Ashley Rose Dudden, CRNP
• Jennifer Renee Dudding, FNP-C
• Tyrone James Dudley, BCBA
• H Jedidiah Duensing, DO
• Katherine A Duff, PA-C
• Thomas Duff, RPH
• Tonya Duff

• Clinical Psychologist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.