Carilion Healthcare Corporation
Organization Active NPI Rural Health Clinic/Center · Wytheville, VA
NPI 1568087476 · NPPES record last updated May 25, 2023
Key facts
- NPI
- 1568087476
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- CARILION HEALTHCARE CORPORATION
- Practice address
- 1375 W Ridge Rd
Wytheville, VA 24382-5011 - Phone
- (276) 228-8686
- NPI assigned
- Jun 16, 2020
- Organization subpart
- Yes
- Parent organization (as reported)
- CARILION HEALTHCARE CORPORATION
Authorized official
- Name
- Nicole Grisetti
- Title
- Director of Operational Support
- Phone
- (540) 224-5352
Change of ownership 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Sep 30, 2020 | Change of Ownership |
Carilion Clinic |
National Provider Directory
- Part of
- Carilion Hlthcare Corp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
1375 W Ridge Rd
Wytheville, VA 24382-5011
Mailing address
213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5372
Other names
- Carilion Clinic Family Medicine
Other providers in Wytheville, VA
- Camelot Outpatient Services, LLC
- Cardinal Pediatric Therapy
- Cardiology Associates of Wytheville
- Carilion Giles Community Hospital
- Carilion Giles Community Hospital
- Miracle Yvonne Carner
- Opal Powell Carrico
- Kerry M Carswell
- Cassandra Simpson, LPC, LLC
- Kelly Renee Cassell
All providers in Wytheville, VA · Rural Health Clinic/Center in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.