NPIMap

Individual provider Active NPI

Paul Reid Gohlke, MD

  • Diagnostic Radiology Physician
  • Blacksburg, VA
National Provider Identifier
1538396361
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101258161 Issued in VA
Practice address
3700 S Main St
Blacksburg, VA 24060-7017
Phone
(540) 953-5130
NPI assigned
Jun 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 156792 NC
Diagnostic Radiology Physician 2085R0202X 0101258161 VA Primary

Addresses

Primary practice location

3700 S Main St
Blacksburg, VA 24060-7017

Mailing address

PO Box 12387
Roanoke, VA 24025-2387
Phone (866) 788-9852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150710001687 VA Practitioner - Diagnostic Radiology 7911143672 Reassigns benefits to 2 organizations
I20250312002048 DC Practitioner - Diagnostic Radiology 7911143672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of North Carolina at Chapel Hill School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reston Radiology Consultants, PCGroup PAC ID 1557436730, 35 clinicians

Practice addresses (Care Compare)

1850 Town Ctr Pkwy
Reston, VA 20190-3204
Phone (703) 478-0922

24440 Stone Springs Blvd
Sterling, VA 20166-2247
Phone (703) 726-1201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
156792NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Radiology Associates Inc Diagnostic Radiology CurrentSince Jul 1, 2015 Accepting new patients
Reston Radiology Consultants, PC Diagnostic Radiology CurrentSince Apr 1, 2025 Accepting new patients
Pet of Reston, LP Diagnostic Radiology PastSince Jan 30, 2023 Accepting new patients

Locations

3700 S Main St
Blacksburg, VA 24060
Phone (540) 951-1111

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

1830 Town Center Dr
Ste 105
Reston, VA 20190
Phone (571) 601-2901

4330 Brambleton Ave
Roanoke, VA 24018
Phone (540) 283-3700

24440 Stone Springs Blvd
Sterling, VA 20166
Phone (571) 206-8696

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1538396361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12387",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240252387",
            "telephone_number": "866-788-9852",
            "fax_number": "540-766-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 S MAIN ST",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607017",
            "telephone_number": "540-953-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOHLKE",
        "first_name": "PAUL",
        "middle_name": "REID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-19",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "156792",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101258161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.