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ROANOKE PEDIATRICS PLLC
NPI 1760158208
Pediatrics in Roanoke, VA

Active since August 16, 2021CLIA 49D2271017 · Waiver
1901 DENNISTON AVE SW, ROANOKE, VA 24015(540) 613-8565 Get Directions Write a Review

NPPES record last updated: June 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 6, 2023, Aug 16, 2021 (2 updates tracked since 2021).

About Roanoke Pediatrics Pllc NPPES

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

ROANOKE PEDIATRICS PLLC (NPI 1760158208) is a healthcare organization registered as a pediatrics in Roanoke, Virginia and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through October 25, 2026 and lists Mathew Henderson, Owner, as its authorized official.

NPPES Registry Identity

NPI1760158208
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameROANOKE PEDIATRICS PLLC
Location Address1901 DENNISTON AVE SWRoanoke, VA 24015-2023
Mailing Address1901 Denniston Ave SwRoanoke, VA 24015-2023 · (540) 613-8565
Phone(540) 613-8565
Organization SubpartNo
Authorized OfficialMathew HendersonOwner · (540) 613-8565
Enumeration DateAugust 16, 2021
Last NPPES UpdateJune 6, 20232 updates tracked since enumeration
NPPES CertifiedJune 6, 2023
✔ NPI 1760158208 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1901 DENNISTON AVE SW, Roanoke, VA 24015
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2271017

Roanoke Pediatrics · Roanoke, VA
Active · expires Oct 25, 2026
CLIA Number49D2271017
Laboratory TypePhysician Office
Certificate Effective DateOctober 26, 2024
Certificate Expiration DateOctober 25, 2026
Laboratory DirectorMathew Henderson
Laboratory Phone(540) 613-8565
Laboratory LocationRoanoke Pediatrics1901 Denniston Ave SW, Roanoke, VA 24015
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

JANET LEE SPITZER M.D.
Family Medicine
1901 DENNISTON AVE SW
ROANOKE, VA 24015
Roanoke City (540) 989-7700
MATHEW HENDERSON DO
Pediatrics
1901 DENNISTON AVE SW
ROANOKE, VA 24015
Roanoke City (540) 613-8565

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roanoke Pediatrics PLLC's NPI number?

The NPI number for Roanoke Pediatrics PLLC is 1760158208. It was assigned to this organization in the NPPES registry on August 16, 2021.

Where is Roanoke Pediatrics PLLC located?

Roanoke Pediatrics PLLC is located at 1901 Denniston Ave SW, Roanoke, VA 24015. The listed phone number is (540) 613-8565.

What is Roanoke Pediatrics PLLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Roanoke Pediatrics PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2271017) is associated with this NPI, valid through October 25, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Roanoke Pediatrics PLLC was last updated on June 6, 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.