David H. Mortlock

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

116019067 Issued in VA

Practice address

4910 Valley View Blvd NW
Roanoke, VA 24012-2040

Phone

(540) 265-1607

Fax

(540) 366-7353

NPI assigned

Jul 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1861691552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 VALLEY VIEW BLVD NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240122040",
            "telephone_number": "540-265-1607",
            "fax_number": "540-366-7353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 VALLEY VIEW BLVD NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240122040",
            "telephone_number": "540-265-1607",
            "fax_number": "540-366-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTLOCK",
        "first_name": "DAVID",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "116019067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861691552",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Penny Marie Morrison
• Kathleen Anne Morrisroe
• Cynthia B Morrow, M.D.
• Quinn Morrow, MD
• David L Mortellaro, LPC, LMFT
• Mosaic Mental Wellness
• Chad W Mosby, M.D.
• Lorin Bonham Moseley
• Joseph Tuvia Moskal, M.D.
• Manyan Moss, PHARMD

• Family Medicine Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.