Individual provider Active NPI

Tara Ann Mitchell, PH.D.

  • Clinical Psychologist
  • Roanoke, VA
National Provider Identifier
1548372311
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810004242 Issued in VA
Practice address
4348 Electric Rd
Roanoke, VA 24018-0720
Phone
(540) 769-0976
Fax
(540) 857-5385
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810004242 VA Primary

Addresses

Primary practice location

4348 Electric Rd
Roanoke, VA 24018-0720

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other names 1

  • Dr. Tara Ann Reyns 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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100610000156 VA Practitioner - Clinical Psychologist 0840320362 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Apr 1, 2010 Accepting new patients
Carilion Medical Center CurrentSince Apr 1, 2010 Accepting new patients
Carilion Healthcare Corporation CurrentSince May 6, 2020 Accepting new patients
Carilion Healthcare Corporation CurrentSince May 6, 2020 Accepting new patients

Locations

60 Market Center Way
Daleville, VA 24083
Phone (540) 992-1251

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

1030 S Jefferson St
Ste 201
Roanoke, VA 24016
Phone (540) 224-4520

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

4348 Electric Rd
Roanoke, VA 24018
Phone (540) 769-0600

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

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1548372311",
    "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"
        },
        {
            "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": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "TARA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "REYNS",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.