Intrepid of Piedmont Ridge, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

HSP 17230 Issued in VA

Legal business name

INTREPID OF PIEDMONT RIDGE, INC.

Doing business as

Intrepid USA Hospice

Practice address

4005 Electric Rd Ste 200
Roanoke, VA 24018-8435

Phone

(540) 523-1160

Fax

(540) 265-2416

NPI assigned

Oct 13, 2016

Last updated

Nov 9, 2022By 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

Robert Parker

Title

Cco

Phone

(214) 445-3750

Specialties & licenses 1

Addresses

Other names 1

• Intrepid USA Hospice Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1487104428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14841 DALLAS PKWY STE 625",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547641",
            "telephone_number": "214-445-3750",
            "fax_number": "214-445-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 ELECTRIC RD STE 200",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240188435",
            "telephone_number": "540-523-1160",
            "fax_number": "540-265-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTREPID OF PIEDMONT RIDGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "214-445-3750"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "VA",
            "license": "HSP 17230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Intrepid USA Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intrepid USA Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community Based Hospice Care Agency in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Community Based Hospice Care Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.