Individual provider Active NPI

Thomas McLeod Baader, DC

  • Chiropractor
  • Roanoke, VA
National Provider Identifier
1720007966
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001231 Issued in VA
Practice address
41 Summers Way
Suite 103
Roanoke, VA 24019-8291
Phone
(540) 966-1423
Fax
(540) 966-4125
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104001231 VA Primary

Addresses

Primary practice location

41 Summers Way
Suite 103
Roanoke, VA 24019-8291

Mailing address

PO Box 25
Blue Ridge, VA 24064-0025
Phone (540) 966-1423

Other identifiers 5

IdentifierTypeStateIssuer
170913OtherVASOUTHERN HEALTH
281817OtherVAANTHEM BLUE CROSS
197924OtherVAANTHEM
350039206OtherVARAILROAD MEDICARE
5115029OtherVAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101014000257 VA Practitioner - Chiropractic 6204028830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

41 Summers Way
Suite 103
Roanoke, VA 24019-8455
Phone (540) 966-1423

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis Spinal Care Inc. Chiropractor CurrentSince Jan 1, 1996 Accepting new patients

Locations

41 Summers Way
Ste 103
Roanoke, VA 24019
Phone (540) 966-1423

Organizations & group practices 1

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1720007966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25",
            "city": "BLUE RIDGE",
            "state": "VA",
            "postal_code": "240640025",
            "telephone_number": "540-966-1423",
            "fax_number": "540-966-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 SUMMERS WAY",
            "address_2": "SUITE 103",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240198291",
            "telephone_number": "540-966-1423",
            "fax_number": "540-966-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAADER",
        "first_name": "THOMAS",
        "middle_name": "MCLEOD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "170913",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "281817",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "197924",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350039206",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5115029",
            "state": "VA"
        }
    ],
    "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 Apr 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.