INDY HEALTH LABS LLC (NPI# 1114483484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114483484 |
| Entity Type | Organization |
| Organization Name | INDY HEALTH LABS LLC |
| Practice Address |
4521 Brambleton Ave Ste 205 Roanoke VA 24018-3432 |
| Practice Telephone | 5406822160 |
| Mailing Telephone | 5406822160 |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2019-06-10 |
| Authorized Official Name | ROBERT LOVETTE PRESSLEY JR. (PRESIDENT) |
| Authorized Official Telephone | 2567976436 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247ZC0005X |
Pathology Specialization: Clinical Laboratory Director, Non-physician |
Technologists, Technicians & Other Technical Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | INDY HEALTH LABS LLC | 3425 Westmoreland Dr, Roanoke, Virginia 24018 |
| Street Address |
4521 BRAMBLETON AVE STE 205 |
| City | ROANOKE |
| State | VA |
| Zip Code | 24018-3432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140253 | Luz Dione Carr | Nurse Practitioner | 1934 Maple Leaf Drive, Roanoke, VA 24018 | 2019-05-21 |
| 1467926527 | Embrace Foster Care, LLC | Foster Care Agency | 3912 Electric Road, Building C, Roanoke, VA 24018 | 2019-01-11 |
| 1174005417 | Roanoke Valley Ent & Allergy PC | Otolaryngology | 2154 Mcvitty Rd, Second Floor, Roanoke, VA 24018 | 2018-09-04 |
| 1265928535 | Jane Willis Warner | Behavior Technician | 3243 Electric Road Building E Suite 1b, Roanoke, VA 24018 | 2018-07-10 |
| 1821584640 | Anchor To Hope Counseling LLC | Counselor | 4370 Starkey Rd Ste 4c-1, Roanoke, VA 24018 | 2018-07-04 |
| 1164938619 | Aurora Domangue | Behavior Technician | 3243 Electric Road, Building E Suite 1b, Roanoke, VA 24018 | 2017-12-20 |
| 1376059089 | Maggie Marie Ridgeway | Behavior Technician | 3243 Electric Rd., Building E Suite 1b, Roanoke, VA 24018 | 2017-12-18 |
| 1700301850 | Nicole Graboski | Speech-Language Pathologist | 4920 Woodmar Drive Sw, Roanoke, VA 24018 | 2017-08-10 |
| 1891215893 | Kimberly Anne Rosenberger | Occupational Therapy Assistant | 2772 Hillbrook Dr., Roanoke, VA 24018 | 2017-06-21 |
| 1083158950 | Encompass Home Health of Roanoke, LLC | Home Health | 5115 Bernard Drive, Suite 205, Roanoke, VA 24018 | 2016-12-13 |
| Find all providers in zip 24018 | ||||
| Taxonomy Code | 247ZC0005X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Pathology |
| Specialization | Clinical Laboratory Director, Non-physician |
| An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. |
| Notes: Source: National Uniform Claim Committee [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053749754 | Rowaida Bedewy | Pathology | 140 Parker Rd W, Suite # A, Danville, VA 24540-7425 | 2013-10-16 |
| 1306031299 | Wendy Golden | Pathology | Lee Street Pathology, Charlottesville, VA 22908-0001 | 2007-09-13 |
| 1194167452 | Eugene Schwilke | Pathology | 450 Southlake Blvd, North Chesterfield, VA 23236-3094 | 2013-07-26 |
| 1326367483 | Tiffany K Roberts | Pathology | 317 Great Bridge Blvd, Suite B, Chesapeake, VA 23320-7008 | 2010-05-27 |
| 1619110475 | Tricity Imaging & Diagnostics | Pathology | 603 S Sycamore St, Petersburg, VA 23803-5814 | 2009-04-09 |
| 1790925873 | Bilal Group LLC | Pathology | 603 S Sycamore St, Petersburg, VA 23803-5814 | 2009-03-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.