NPIMap

Organization Active NPI

Roanoke Valley Health Services, Inc

Doing business as Roanoke Valley Surgical Associates

  • Surgery Physician
  • Roanoke Rapids, NC
National Provider Identifier
1477902500
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ROANOKE VALLEY HEALTH SERVICES, INC
Doing business as
Roanoke Valley Surgical Associates
Practice address
97 Hwy 125
Roanoke Rapids, NC 27870-4942
Phone
(252) 537-1933
NPI assigned
Jun 9, 2016
Last updated
Jun 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Authorized official

Name
Sherry Jensen
Title
VP, Finance
Phone
(252) 535-8005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

97 Hwy 125
Roanoke Rapids, NC 27870-4942

Mailing address

210 Smith Church Rd Ste B
Roanoke Rapids, NC 27870-4942
Phone (252) 535-8861

Other names 1

  • Roanoke Valley Surgical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050119001033 NC Part B Supplier - Clinic/Group Practice 4587573159 Receives reassigned benefits from 9 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, NC; Knightdale, NC; Roanoke Rapids, NC

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1477902500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 SMITH CHURCH RD STE B",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704942",
            "telephone_number": "252-535-8861",
            "fax_number": "252-535-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 HWY 125",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704942",
            "telephone_number": "252-537-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROANOKE VALLEY HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "VP, FINANCE",
        "authorized_official_telephone_number": "252-535-8005"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roanoke Valley Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke Rapids, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.