NPIMap

Individual provider Active NPI

Michael S La Rue, PA-C

  • Medical Physician Assistant
  • Low Moor, VA
National Provider Identifier
1972508059
Registry record updated Aug 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110001381 Issued in VA
Practice address
Partricia W Henderson DO PC
1 Arh Lane, Ste 800
Low Moor, VA 24457
Phone
(540) 862-6750
Fax
(540) 862-3742
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110001381 VA Primary

Addresses

Primary practice location

Partricia W Henderson DO PC
1 Arh Lane, Ste 800
Low Moor, VA 24457

Mailing address

PO Box 629
Clifton Forge, VA 24422-0629
Phone (540) 862-6659

Other identifiers 2

IdentifierTypeStateIssuer
260538432OtherTRICARE
1972508059MedicaidVA

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
I20080710000284 VA Practitioner - Physician Assistant 3274605092 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Rockbridge Community HospitalGroup PAC ID 4789658261, shared by 10 NPIs, 104 clinicians

Practice addresses (Care Compare)

108 Houston St
Lexington, VA 24450-2455

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Staunton, VA, CCN 497646
  • Carilion Stonewall Jackson Hospital Hospital, Lexington, VA, CCN 491304
  • Lewisgale Hospital Alleghany Hospital, Low Moor, VA, CCN 490126
  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Jun 1, 2016 Accepting new patients
Carilion Rockbridge Community Hospital CurrentSince Dec 14, 2015 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jun 1, 2016 Accepting new patients
Wvva Health Care Alliance, PC Past Accepting new patients

Locations

1 Health Cir
Lexington, VA 24450
Phone (540) 458-3300

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

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

Interoperability endpoints

  • Direct secure messaging: mlarue72528@direct.carilionclinic.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1972508059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "CLIFTON FORGE",
            "state": "VA",
            "postal_code": "244220629",
            "telephone_number": "540-862-6659",
            "fax_number": "540-862-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PARTRICIA W HENDERSON DO PC",
            "address_2": "1 ARH LANE, STE 800",
            "city": "LOW MOOR",
            "state": "VA",
            "postal_code": "24457",
            "telephone_number": "540-862-6750",
            "fax_number": "540-862-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA RUE",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110001381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "260538432",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972508059",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Low Moor, VA

Sources for this page

Verify at the official NPI Registry.