RODNEY JAMES SNODGRASS DEATON M.D.
Complete NPI Record 1003934274
Psychiatry & Neurology - Psychiatry in Roanoke, VA

Active since March 27, 2007PECOS EnrolledAccepts Medicare Assignment
2017 JEFFERSON ST SW, ROANOKE, VA 24014(540) 981-8025 Get Directions

NPPES record last updated: September 15, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 15, 2025, May 29, 2025, Dec 26, 2024 and 8 more (11 updates tracked since 2019).

Complete NPI Dataset

This page contains the complete raw NPPES record for Rodney James Snodgrass Deaton, M.D. (NPI 1003934274), an individual psychiatry & neurology provider in Roanoke, VA. All 57 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.

Registry File Document Utilities
NPI: 1003934274
Field 1/57
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Field 2/57
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Last Name Legal Name: DEATON
Field 3/57
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: RODNEY
Field 4/57
The first name of the provider, if the provider is an individual.
Provider Middle Name: JAMES SNODGRASS
Field 5/57
The middle name of the provider, if the provider is an individual.
Provider Credential Text: M.D.
Field 6/57
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 213 S JEFFERSON ST STE 1006
Field 7/57
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City Name: ROANOKE
Field 8/57
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: VA
Field 9/57
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 240111713
Field 10/57
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
Field 11/57
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider First Line Business Practice Location Address: 2017 JEFFERSON ST SW
Field 12/57
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: ROANOKE
Field 13/57
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: VA
Field 14/57
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 240142419
Field 15/57
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
Field 16/57
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 5409818025
Field 17/57
The telephone number associated with the location address of the provider being identified.
Provider Gender Code: M
Field 20/57
The code designating the provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 2084P0800X
Field 21/57
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 50000
Field 22/57
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 1: TN
Field 23/57
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 1: N
Field 24/57
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 2: 2084P0800X
Field 25/57
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 2: CDR.0004378
Field 26/57
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 2: CO
Field 27/57
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 2: N
Field 28/57
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 3: 2084P0800X
Field 29/57
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 3: 01031938A
Field 30/57
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 3: IN
Field 31/57
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 3: N
Field 32/57
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 4: 2084P0800X
Field 33/57
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 4: 202566
Field 34/57
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 4: AK
Field 35/57
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 4: N
Field 36/57
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 5: 2084P0800X
Field 37/57
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 5: MD61408068
Field 38/57
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 5: WA
Field 39/57
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 5: N
Field 40/57
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 6: 2084P0800X
Field 41/57
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 6: 0101277055
Field 42/57
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 6: VA
Field 43/57
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 6: Y
Field 44/57
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 7: 2084P0800X
Field 45/57
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 7: 75956
Field 46/57
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 7: MN
Field 47/57
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 7: N
Field 48/57
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 8: 2084P0800X
Field 49/57
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 8: 4301116311
Field 50/57
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 8: MI
Field 51/57
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 8: N
Field 52/57
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Other Provider Identifier 1: 100323830
Field 53/57
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 1: 05
Field 54/57
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 1: IN
Field 55/57
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Is Sole Proprietor: N
Field 56/57
Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.

Secondary Practice Locations 23

The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.

3443 Dickerson Pike, Suite 640
Location 1/23
Nashville, TN 37207-2519 · Phone (615) 860-6500 · Fax (615) 250-0464
130 W Ravine Rd
Location 2/23
Kingsport, TN 37660-3837 · Phone (423) 224-4000
1 Medical Park Blvd
Location 3/23
Bristol, TN 37620-7430 · Phone (423) 844-1121
2000 Brookside Dr
Location 4/23
Kingsport, TN 37660-4627 · Phone (423) 857-7000
3100 Tongass Ave
Location 5/23
Ketchikan, AK 99901-5746 · Phone (907) 228-7660 · Fax (907) 228-8549
300 Med Tech Pkwy
Location 6/23
Johnson City, TN 37604-2277 · Phone (423) 302-1000
127 Health Care Dr
Location 7/23
Pennington Gap, VA 24277-2853 · Phone (276) 299-5000
1990 Holton Ave E
Location 8/23
Big Stone Gap, VA 24219-3350 · Phone (276) 523-3111
11600 W 2nd Pl
Location 9/23
Lakewood, CO 80228-1527 · Phone (720) 321-0000 · Fax (720) 321-4165
400 NE Mother Joseph Pl
Location 10/23
Vancouver, WA 98664-3200 · Phone (360) 514-3191 · Fax (360) 729-3372
1615 Delaware St
Location 11/23
Longview, WA 98632-2367 · Phone (360) 636-4836 · Fax (360) 636-6792
245 Medical Park Dr
Location 12/23
Marion, VA 24354-1100 · Phone (276) 378-1000
16000 Johnston Memorial Dr
Location 13/23
Abingdon, VA 24211-7664 · Phone (276) 258-1000
1901 S Shady St
Location 14/23
Mountain City, TN 37683-2021 · Phone (423) 727-1100
2030 Temple Hill Rd
Location 15/23
Erwin, TN 37650-8721 · Phone (423) 743-3141
1501 W Elk Ave
Location 16/23
Elizabethton, TN 37643-2874 · Phone (423) 542-1300
312 Hospital Dr
Location 17/23
Clintwood, VA 24228-6786 · Phone (276) 926-0300
58 Carroll Street
Location 18/23
Lebanon, VA 24266-4510 · Phone (276) 883-8000
400 N State Of Franklin Rd
Location 19/23
Johnson City, TN 37604-6035 · Phone (423) 431-6111
851 Locust St
Location 20/23
Rogersville, TN 37857-2407 · Phone (423) 921-7000
4050 Coon Rapids Blvd NW
Location 21/23
Coon Rapids, MN 55433-2522 · Phone (612) 262-1220
1420 Tusculum Blvd
Location 22/23
Greeneville, TN 37745-4279 · Phone (423) 787-5000
1519 Main St
Location 23/23
Sneedville, TN 37869-3657 · Phone (423) 733-5000

Other Provider Identifiers 1

Legacy and payer-issued identifiers reported to the NPPES registry for this provider.

100323830 Medicaid
Identifier 1/1
State: IN
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
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