MARY C. VANDERGRIFT PA-C
NPI 1518041722
Physician Assistant in Roanoke, VA

Q: What is Mary Vandergrift's NPI number?

The NPI number for Mary Vandergrift is 1518041722. It was assigned to this individual provider in the NPPES registry on October 24, 2006. The provider is also known as Mary C. Kiser Pa-C.

Q: What is Mary Vandergrift's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Vandergrift was last updated on April 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 24, 2006

5673 AIRPORT RD, ROANOKE, VA 24012(540) 523-8080(540) 562-8867 Get Directions Write a Review

NPPES record last updated: April 20, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 7, 2023, Jun 30, 2016 (2 updates tracked since 2016).

On this page

About Mary C. Vandergrift Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY C. VANDERGRIFT PA-C (NPI 1518041722) is an individual physician assistant in Roanoke, Virginia, licensed in Virginia (0110002290) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1518041722

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMARY C. VANDERGRIFTCredential: PA-C

Location Address5673 AIRPORT RDRoanoke, VA 24012-1119

Mailing Address213 S Jefferson St Ste 1006Roanoke, VA 24011-1713 · (540) 224-5352

Phone(540) 523-8080

Fax(540) 562-8867

Sole ProprietorNo

Enumeration DateOctober 24, 2006

Last NPPES UpdateApril 20, 20232 updates tracked since enumeration

NPPES CertifiedApril 20, 2023

✔ NPI 1518041722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in VA · 0110002290

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

5673 AIRPORT RD, Roanoke, VA 24012

Open in Google Maps ↗

Other Names 1

Former Name (1)Mary C. Kiser Pa-c

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JARED WATERS

Physician Assistant