NPIMap

Organization Active NPI

Premier Geriatric Solutions PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Roanoke, VA
National Provider Identifier
1568093672
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
PREMIER GERIATRIC SOLUTIONS PLLC
Practice address
6701 Peters Creek Rd Ste 110
Roanoke, VA 24019-4060
Phone
(800) 765-7130
Fax
(201) 228-9980
NPI assigned
Jan 28, 2020
Last updated
Feb 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Authorized official

Name
Dr. Bradley Jackson Goad, DONPI 1285617241
Title
Owner
Phone
(540) 488-2200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

6701 Peters Creek Rd Ste 110
Roanoke, VA 24019-4060

Mailing address

6701 Peters Creek Rd Ste 110
Roanoke, VA 24019-4060
Phone (800) 765-7130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC, WV3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20200228001800 VA Part B Supplier - Clinic/Group Practice 3072940279 Receives reassigned benefits from 91 practitioners
Practice locations: Roanoke, VA
O20210624000938 NC Part B Supplier - Clinic/Group Practice 3072940279 Receives reassigned benefits from 19 practitioners
Practice locations: Sparta, NC
O20240404004244 WV Part B Supplier - Clinic/Group Practice 3072940279 Receives reassigned benefits from 2 practitioners
Practice locations: Princeton, WV

National Provider Directory

National Provider Directory

Locations

12787 Booker T Washington Hwy
Ste 104
Hardy, VA 24101

6710 Peters CRK Rd Ste 100
Roanoke, VA 24019

Practitioners & affiliated clinicians

Practitioners 97

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 97

NPI Registry JSON

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612828800000",
    "number": "1568093672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 PETERS CREEK RD STE 110",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240194060",
            "telephone_number": "800-765-7130",
            "fax_number": "201-228-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 PETERS CREEK RD STE 110",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240194060",
            "telephone_number": "800-765-7130",
            "fax_number": "201-228-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER GERIATRIC SOLUTIONS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A",
        "authorized_official_last_name": "GOAD",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-488-2200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.