Walnut Avenue Associates PC

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

Legal business name

WALNUT AVENUE ASSOCIATES PC

Practice address

16 Walnut Ave SW
Roanoke, VA 24016-4719

Phone

(540) 345-6468

Fax

(540) 345-3204

NPI assigned

Sep 27, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jitendra S Desai, M.D.NPI 1942281019

Title

Owner

Phone

(540) 345-6468

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jitendra S Desai, MD

  • Psychiatry Physician
  • Roanoke, VA
  • NPI 1942281019
  Medicare reassignment Care Compare group NPD Authorized official
• Xiaofang Ingram

  • Psychiatric/Mental Health Nurse Practitioner
  • Roanoke, VA
  • NPI 1912604737
  Medicare reassignment Care Compare group NPD
• Amanda Elise Richardson, PA

  • Physician Assistant
  • Floyd, VA
  • NPI 1578953303
  Medicare reassignment Care Compare group
• Sarah Nell Rodes, PA-C

  • Physician Assistant
  • Roanoke, VA
  • NPI 1821052218
  Medicare reassignment Care Compare group
• Molly Barrett Sharp, PA - C

  • Physician Assistant
  • Roanoke, VA
  • NPI 1922257088
  Medicare reassignment Care Compare group
• Puja Ganjwala

  • Family Nurse Practitioner
  • Roanoke, VA
  • NPI 1790188266
  Medicare reassignment NPD
• Sachinder Vasudeva, MD

  • Psychiatry Physician
  • Salem, VA
  • NPI 1053387167
  Medicare reassignment NPD
• Michelle Whittaker, FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Roanoke, VA
  • NPI 1841721891
  Medicare reassignment NPD
• Amaninder Grewal, PMHNP, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
  • NPI 1467166355

  VA

  Medicare reassignment NPD
• Jessica Spencer Gillispie, PA-C

  • Physician Assistant
  • Roanoke, VA
  • NPI 1912244930
  Medicare reassignment
• Benedict A Profera, DPM, MPH

  • Primary Podiatric Medicine Podiatrist
  • Salem, VA
  • NPI 1356497622
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861583791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WALNUT AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164719",
            "telephone_number": "540-345-6468",
            "fax_number": "540-345-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WALNUT AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164719",
            "telephone_number": "540-345-6468",
            "fax_number": "540-345-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT AVENUE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "JITENDRA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-345-6468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorian Wallace, OT/R
• Ashley Mariah Wallen
• Dominique Waller
• Tara Waller
• Melissa Walls, PHARMD
• Sonnie C Walsh, LPTA
• Walter B. Blair,M.D., Inc
• Walter Chiropractic Clinic
• Gregory L Walter, DC
• Melanie Rebecca Walter, M.D.

• Addiction Psychiatry Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Addiction Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.