Individual provider Active NPI

Mary Gayle Sweet, MD

  • Family Medicine Physician
  • Roanoke, VA
National Provider Identifier
1588655807
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101-227058 Issued in VA
Practice address
1314 Peters Creek Rd NW
Roanoke, VA 24017-2500
Phone
(540) 562-5700
NPI assigned
Nov 4, 2005
Last updated
Aug 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101-227058 VA Primary

Addresses

Primary practice location

1314 Peters Creek Rd NW
Roanoke, VA 24017-2500

Mailing address

6210 Juliet CT
Roanoke, VA 24018-7796
Phone (540) 776-7738

Other identifiers 2

IdentifierTypeStateIssuer
5616336MedicaidVA
5619149MedicaidVA

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
I20080730000514 VA Practitioner - Family Practice 0345314928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

1314 Peters Creek Rd
Roanoke, VA 24017-2500
Phone (540) 562-5700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101-227058VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince May 23, 2008 Accepting new patients
Carilion Medical Center CurrentSince May 23, 2008 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

1314 Peters Creek Rd NW
Roanoke, VA 24017
Phone (540) 427-9200

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

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

Interoperability endpoints

  • Direct secure messaging: msweet16378@direct.carilionclinic.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1588655807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 JULIET CT",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240187796",
            "telephone_number": "540-776-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 PETERS CREEK RD NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240172500",
            "telephone_number": "540-562-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEET",
        "first_name": "MARY",
        "middle_name": "GAYLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101-227058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5616336",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5619149",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.