Individual provider Active NPI

Mary Ann Rosevear Cladis, M.D.

  • Family Medicine Physician
  • Roanoke, VA
National Provider Identifier
1518386283
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101276442 Issued in VA
Practice address
4035 Electric Rd Ste a
Roanoke, VA 24018-8449
Phone
(540) 772-8670
NPI assigned
Apr 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 67341 MN
Family Medicine Physician 207Q00000X 0101276442 VA Primary

Addresses

Primary practice location

4035 Electric Rd Ste a
Roanoke, VA 24018-8449

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5352

Other names 1

  • Mary Ann Rosevear Lesch Former name

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
I20221228001567 VA Practitioner - Family Practice 1254556012 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Feb 13, 2023 Accepting new patients
Carilion Healthcare Corporation CurrentSince Feb 13, 2023 Accepting new patients
Carilion Emergency Services, Inc. Family Medicine CurrentSince Feb 13, 2023 Accepting new patients

Locations

434 Peppers Fry Rd NW
Christiansburg, VA 24073
Phone (540) 382-6000

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

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

4035 Electric Rd
Ste A
Roanoke, VA 24018
Phone (540) 772-8670

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1518386283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 ELECTRIC RD STE A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240188449",
            "telephone_number": "540-772-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLADIS",
        "first_name": "MARY ANN",
        "middle_name": "ROSEVEAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "67341",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101276442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ANN",
            "last_name": "LESCH",
            "middle_name": "ROSEVEAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.