NPIMap

Individual provider Active NPI

Isaac Spence, D.O.

  • Family Medicine Physician
  • Blacksburg, VA
National Provider Identifier
1760772552
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102-203787 Issued in VA
Practice address
901 Plantation Rd
Suite 1
Blacksburg, VA 24060-3880
Phone
(540) 951-0352
Fax
(540) 951-7724
NPI assigned
Apr 13, 2011
Last updated
Dec 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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 0102-203787 VA Primary

Addresses

Primary practice location

901 Plantation Rd
Suite 1
Blacksburg, VA 24060-3880

Mailing address

901 Plantation Rd
Suite 1
Blacksburg, VA 24060-3880
Phone (540) 951-0352

Other identifiers 1

IdentifierTypeStateIssuer
VVE193AOtherVAMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ispence10805@direct.carilionclinic.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140826002955 VA Practitioner - Family Practice 3577781954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Practice addresses (Care Compare)

6415 Peters Creek Rd
Roanoke, VA 24019-4021
Phone (703) 562-2110

981 Litton LN
Blacksburg, VA 24060-6340
Phone (540) 558-2400

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
0102-203787VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Aug 11, 2014 Accepting new patients
Carilion Healthcare Corporation CurrentSince Aug 11, 2014 Accepting new patients

Locations

901 Plantation Rd
Ste 1
Blacksburg, VA 24060
Phone (540) 951-0352

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

Interoperability endpoints

  • Direct secure messaging: ispence10805@direct.carilionclinic.org

Organizations & group practices 2

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 11

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": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1760772552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 PLANTATION RD",
            "address_2": "SUITE 1",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240603880",
            "telephone_number": "540-951-0352",
            "fax_number": "540-951-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 PLANTATION RD",
            "address_2": "SUITE 1",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240603880",
            "telephone_number": "540-951-0352",
            "fax_number": "540-951-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-13",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102-203787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "VVE193A",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ispence10805@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ispence10805@direct.carilionclinic.org",
            "address_1": "901 Plantation Rd",
            "address_2": "Suite 1",
            "city": "Blacksburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240603880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.