Roanoke Pediatrics PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

ROANOKE PEDIATRICS PLLC

Practice address

1901 Denniston Ave SW
Roanoke, VA 24015-2023

Phone

(540) 613-8565

NPI assigned

Aug 16, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Mathew Henderson, DONPI 1215323837

Title

Owner

Phone

(540) 613-8565

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mathew Henderson, DO

  • Pediatrics Physician
  • Roanoke, VA
  • NPI 1215323837
  NPD Authorized official

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1760158208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 DENNISTON AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240152023",
            "telephone_number": "540-613-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 DENNISTON AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240152023",
            "telephone_number": "540-613-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROANOKE PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-613-8565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roanoke Orthopaedic Center, Inc.
• Roanoke Orthopaedic Center, Inc.
• Roanoke Orthopedic Appliance Co Inc
• Roanoke Partners in Health, PC
• Roanoke Pediatric Dentistry, LLC
• Roanoke Physician Services, LLC
• Roanoke Plastic Surgery PLC
• Roanoke Premier Medicine LLC
• Roanoke Rehab & Healthcare Center LLC
• Roanoke Rehab and Healthcare Center LLC

• Pediatrics Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.