NPIMap

Organization Active NPI

Carilion Rockbridge Community Hospital

  • Emergency Medicine Physician
  • Lexington, VA
National Provider Identifier
1942854427
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CARILION ROCKBRIDGE COMMUNITY HOSPITAL
Practice address
1 Health Cir
Lexington, VA 24450-2448
Phone
(540) 458-3300
NPI assigned
Aug 1, 2019
Last updated
Dec 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Authorized official

Name
Nicole Grisetti
Title
Authorized Official
Phone
(540) 224-5405

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

1 Health Cir
Lexington, VA 24450-2448

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040820000838 VA Part B Supplier - Clinic/Group Practice 4789658261 Receives reassigned benefits from 629 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carrollton, VA; Norfolk, VA; Lexington, VA; Buena Vista, VA; Buchanan, VA; Bluefield, VA; Bedford, VA
O20070924000106 VA Part A Provider - Critical Access Hospital 4789658261 Receives reassigned benefits from 108 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lexington, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942854427. Details of each certification follow.

Hospital certification: CCN 491304

Legal name
CARILION ROCKBRIDGE COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 1, 2004
Last certification
May 28, 2013
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 2005 in VA
Enrollment address
1 Health Cir
Lexington, VA 24450-2448
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Carilion Stonewall Jackson HospitalCCN 491304 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Carilion Rockbridge Community Hospital11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly Shaw Individual Corporate Officer Oct 1, 2021
Amy Dehart Individual Corporate Officer Oct 1, 2021
George Robert Vaughan Individual Corporate DirectorTreasurer Jan 1, 2010
Gregory Madsen Individual Corporate Officer Oct 1, 2021
Eleanor Prescott Individual Corporate DirectorDirector of Payer Contracting Coord Oct 14, 2025
Joshua Hartle Individual Corporate DirectorDirector of Provider Enrollment Oct 6, 2025
Donald B Halliwill Individual Corporate Director Jan 1, 2011
W-2 Managing Employee Jan 1, 2011
Matthew Barr Individual Corporate DirectorMember, Board of Directors Jan 1, 2025
Carilion Clinic Organization, Roanoke, VA Corporation 5% Or Greater Direct Ownership Interest Jul 1, 2005 100%
Operational/Managerial Control Jul 1, 2005
Kristina Dukes Werner Individual Corporate DirectorMember, Board of Directors Jan 1, 2026
Reginald Early Individual Corporate DirectorMember, Board of Directors Oct 1, 2023
Marylin E Alexander Individual Corporate Officer Oct 1, 2021
Tracy Lyons Individual Corporate Officer Oct 1, 2021
Joshua Elrod Individual Corporate Director Sep 30, 2022
Ayesha Kelly Individual Corporate DirectorMember, Board of Directors Jan 1, 2024
Alicia S Devine Individual Corporate Officer Oct 1, 2021
Nathan Ramsey Individual Corporate Director Sep 30, 2022
Kimberly Reynolds Individual W-2 Managing Employee May 22, 2023
Duaine Fitzgerald Individual Corporate Officer Oct 1, 2021

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

Affiliated clinicians 201

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 201

NPI Registry JSON

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1942854427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5372",
            "fax_number": "540-224-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTH CIR",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244502448",
            "telephone_number": "540-458-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARILION ROCKBRIDGE COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-01",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "GRISETTI",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "540-224-5405"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, VA

Sources for this page

Verify at the official NPI Registry.