Jason Charles Grove, DO
Individual provider Active NPI Psychiatry Physician · Roanoke, VA
NPI 1982801288 · NPPES record last updated Feb 27, 2024
Key facts
- NPI
- 1982801288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 0102202832 (VA)
- Practice address
- 5115 Bernard Dr
Suite 105
Roanoke, VA 24018-4357 - Phone
- (540) 728-1570
- NPI assigned
- Jun 29, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 2007
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Tri Area Community Health
Practice addresses (Care Compare)
140 Christiansburg Nepike
Floyd, VA 24091-3742
Phone (540) 745-9290
5115 Bernard Dr
Suite 105
Roanoke, VA 24018-4367
Phone (540) 728-1570
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140808002124 | VA | Practitioner - Psychiatry | 7315115250 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0116019726 | VA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri Area Community Health | Current | Accepting new patients | |
| Mountain Psychiatric, LLC | Psychiatry | Current |
Accepting new patients |
| Tri Area Community Health | Current |
Accepting new patients | |
| Tri Area Community Health | Current |
Accepting new patients |
Locations
140 Christiansburg Pike NE
Floyd, VA 24091
Phone (540) 745-9290
14558 Danville Pike
#9
Laurel Fork, VA 24352
Phone (540) 398-2292
14558 Danville Pike
Laurel Fork, VA 24352
Phone (276) 398-1200
5115 Bernard Dr
Ste 105
Roanoke, VA 24018
Phone (540) 728-1570
Interoperability endpoints
- jason.grove@tachc.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 0116019726 | VA | |
| Psychiatry Physician | 2084P0800X | 0102202832 | VA | Yes |
Addresses
Primary practice location
5115 Bernard Dr
Suite 105
Roanoke, VA 24018-4357
Mailing address
5115 Bernard Dr
Suite 105
Roanoke, VA 24018-4357
Phone (540) 728-1570
Other practice location 1
140 Christiansburg Pike NE
Floyd, VA 24091-3742
Phone (540) 745-9290
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982801288 | Medicaid | VA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | wedonotuse |
Other providers in Roanoke, VA
- Austin Matthew Grooms
- Crystal Marie Grooms
- Mason Gross
- Sir Prell Gross
- Daniel Groth
- GST Management Company
- Susan Fowler Guelich
- Kurt W Guelzow
- Karla Guerra
- Jocelyn Guerrero
All providers in Roanoke, VA · Psychiatry Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.