Active NPI
Charlotta Jornlid
- Internal Medicine Physician
- Roanoke, VA
National Provider Identifier
1689202822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- DO01353
- Practice address
- 3 Riverside Cir
Roanoke, VA 24016-4955 - Phone
- (540) 224-5170
- Fax
- (540) 983-8229
- NPI assigned
- Apr 1, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0102207742 | VA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | DO01353 | RI | Primary |
Addresses
Primary practice location
3 Riverside Cir
Roanoke, VA 24016-4955
Mailing address
117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779
Other practice location 1
1906 Belleview Ave
Carilion Roanoke Memorial Hospital
Roanoke, VA 24014
Phone (540) 981-7000
Other practice location 2
593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-3985
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4000
Hospital & facility affiliations
- Rhode Island Hospital
- The Miriam Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespan Corporation | Current | Accepting new patients | |
| Lifespan Physician Group, Inc. | Current | Accepting new patients | |
| Lifespan Physician Group, Inc. | Current | Accepting new patients |
Locations
185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050
593 Eddy St
Providence, RI 02903
117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318
Interoperability endpoints
- cjornlid224920@brownhealth.medalliesdirect.net
- charlotta.jornlid.1@18289.direct.athenahealth.com
- cjornlid125372@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 and National Provider Directory roles.
-
- General Practice Physician
- Providence, RI
- NPI 1407116643
-
- Children's Rehabilitation Hospital
- Providence, RI
- NPI 1790221232
-
- Emergency Medicine Physician
- Providence, RI
- NPI 1568325678
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Providence, RI
- NPI 1588659528
-
- General Acute Care Hospital
- Providence, RI
- NPI 1972768174
-
- General Acute Care Hospital
- Providence, RI
- NPI 1487649430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720569600000",
"number": "1689202822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 ELLENFIELD ST STE 101",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029054541",
"telephone_number": "401-444-6779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 RIVERSIDE CIR",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240164955",
"telephone_number": "540-224-5170",
"fax_number": "540-983-8229"
}
],
"practiceLocations": [
{
"address_1": "1906 Belleview Ave",
"address_2": "Carilion Roanoke Memorial Hospital",
"address_purpose": "LOCATION",
"city": "Roanoke",
"state": "VA",
"postal_code": "24014",
"country_code": "US",
"telephone_number": "540-981-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "593 Eddy St",
"address_purpose": "LOCATION",
"city": "Providence",
"state": "RI",
"postal_code": "029034923",
"country_code": "US",
"telephone_number": "401-444-3985",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JORNLID",
"first_name": "CHARLOTTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-01",
"last_updated": "2024-07-10",
"certification_date": "2024-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0102207742",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "RI",
"license": "DO01353",
"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 Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.