Individual provider Active NPI

Tammy M Radford, P.A.-C

  • Physician Assistant
  • Roanoke, VA
National Provider Identifier
1609970847
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002144 Issued in VA
Practice address
1906 Belleview Ave SE
Emergency Dept.
Roanoke, VA 24014-1838
Phone
(540) 981-7000
Fax
(540) 981-9550
NPI assigned
Sep 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110002144 VA
Physician Assistant 363A00000X 0110002144 VA Primary

Addresses

Primary practice location

1906 Belleview Ave SE
Emergency Dept.
Roanoke, VA 24014-1838

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5352

Other identifiers 3

IdentifierTypeStateIssuer
010206600MedicaidVA
010206596MedicaidVA
010206561MedicaidVA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060113000636 VA Practitioner - Physician Assistant 4284657479 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110002144VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Jan 1, 2014 Accepting new patients
Carilion Medical Center CurrentSince Mar 29, 2009 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jan 1, 2014 Accepting new patients
Carilion Medical Center CurrentSince Feb 21, 2016 Accepting new patients
Carilion Medical Center CurrentSince Mar 29, 2009 Accepting new patients

Locations

434 Peppers Fry Rd NW
Christiansburg, VA 24073
Phone (540) 382-6000

6801 Governor Gc Peery Hwy
Richlands, VA 24641
Phone (276) 523-8600

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

102 Highland Ave SE
Ste 303
Roanoke, VA 24013
Phone (540) 344-3020

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

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

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: tradford22254@direct.carilionclinic.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1609970847",
    "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",
            "telephone_number": "540-224-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "address_2": "EMERGENCY DEPT.",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-7000",
            "fax_number": "540-981-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADFORD",
        "first_name": "TAMMY",
        "middle_name": "M",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002144",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010206600",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010206596",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010206561",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.