BALANCE WELLSPACE INTEGRATIVE MEDICINE, INC. (NPI# 1164966446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164966446 |
| Entity Type | Organization |
| Organization Name | BALANCE WELLSPACE INTEGRATIVE MEDICINE, INC. |
| Practice Address |
2110 Carolina Ave Sw Roanoke VA 24014-1738 |
| Practice Telephone | 5403430055 |
| Practice Fax Number | 5403430056 |
| Mailing Telephone | 5403430055 |
| Mailing Fax Number | 5403430056 |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2016-12-06 |
| Authorized Official Name | DR. JENNIFER WALKER (PRESIDENT) |
| Authorized Official Telephone | 5403430055 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
2110 CAROLINA AVE SW |
| City | ROANOKE |
| State | VA |
| Zip Code | 24014-1738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649200130 | Jennifer E Walker | Chiropractor | 2110 Carolina Ave Sw, Roanoke, VA 24014-1738 | 2006-07-03 |
| 1508365875 | Nicole Marie Dougherty | Chiropractor | 2110 Carolina Ave Sw, Roanoke, VA 24014-1738 | 2018-02-01 |
| 1053763847 | Anna Occhiuzzi-flynn | Chiropractor | 2110 Carolina Ave Sw, Roanoke, VA 24014-1738 | 2016-07-06 |
| 1750750915 | Stephen Hussey | Chiropractor | 2110 Carolina Ave Sw, Roanoke, VA 24014-1738 | 2015-09-17 |
| 1154714764 | Kimberly Williams | Chiropractor | 2110 Carolina Ave Sw, Roanoke, VA 24014-1738 | 2015-03-07 |
| 1821192451 | Cape Chiropractic Inc | Chiropractor | 2110 Carolina Ave Sw, Roanoke, VA 24014-1738 | 2006-09-12 |
| 1598790115 | South Roanoke Ob-gyn PC | Obstetrics & Gynecology | 2110 Carolina Ave Sw, 3rd Floor, Roanoke, VA 24014-1702 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558602 | Irene Pace Seidman | Pharmacist | 3350 Clearbrook Village Ln, Roanoke, VA 24014 | 2020-11-04 |
| 1720617970 | Mounica Reddy Thootkur | Student in an Organized Health Care Education/Training Program | 2017 South Jefferson Street, 2nd Floor, Roanoke, VA 24014 | 2020-04-08 |
| 1326675422 | Bharath Muppala | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2020-03-26 |
| 1235629239 | Sanjeeb Sudarshan Bhandari | Student in an Organized Health Care Education/Training Program | 1906 Bellview Ave Se, Roanoke, VA 24014 | 2018-05-15 |
| 1104325778 | Vera J. Short | Registered Nurse | 3167 Huffman Ln, Roanoke, VA 24014 | 2018-02-08 |
| 1770001380 | Michael Alan Phillips I | Social Worker | 2017 Jefferson Street, Roanoke, VA 24014 | 2017-09-03 |
| 1306362884 | Sara Alicia Guasch | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2017-08-16 |
| 1790212256 | Pouya Mafi | Student in an Organized Health Care Education/Training Program | 1906 Belleview Ave, Carilion Roanoke Memorial Hospital, Roanoke, VA 24014 | 2017-05-16 |
| 1790222867 | Mara Cate | Physician Assistant | 523 Arbuttus Ave, Roanoke, VA 24014 | 2017-01-26 |
| 1508314634 | Dknl Enterprises, Inc. | Non-emergency Medical Transport (VAN) | 3629 Franklin Rd Sw Suite 205b, Roanoke, VA 24014 | 2016-09-19 |
| Find all providers in zip 24014 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619147691 | Max Erwin Bertholf | General Practice | 498 Coyner Springs Rd, Roanoke Valley Juvenile Detention Center, Med. Director, Roanoke, VA 24012-9038 | 2008-03-06 |
| 1073625109 | Scott Crawford Hippeard | General Practice | 4901 Brambleton Ave, Roanoke, VA 24018-4149 | 2006-08-31 |
| 1407836885 | Starkey Medical | General Practice | 4903 Starkey Rd, Ste 300, Roanoke, VA 24018 | 2006-01-20 |
| 1477550051 | J Melburn D Holmes | General Practice | 1950 Main St, Roanoke, AL 36274-2421 | 2005-06-28 |
| 1407498397 | Integrated Wound Care Virginia Pllc | General Practice | 324 King George Ave Sw, Roanoke, VA 24016-5213 | 2019-10-11 |
| 1326220591 | J Melburn D Holmes | General Practice | 32 Medical Dr, Ste 7, Roanoke, AL 36274-2421 | 2007-11-29 |
| 1538294640 | Southwest Medical Clinic | General Practice | 4079 Electric Rd, Roanoke, VA 24018-8442 | 2007-02-22 |
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|---|---|---|---|---|
| 1225637242 | Hastings Healthcare, LLC | General Practice | Hastings Medical Clinic of Bridgewater, 110 North Main Street Suite A, Bridgewater, VA 22812 | 2020-10-21 |
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| 1407465289 | Martine H Long | General Practice | 515 Cornerstone St, Lynchburg, VA 24502-5342 | 2020-07-28 |
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| 1851929558 | Medical Care for Family LLC | General Practice | 6408k Seven Corners Pl Ste G, Falls Church, VA 22044-2007 | 2020-03-29 |
| 1104389337 | Bardia Nemati | General Practice | 731 Walker Rd # E1, Great Falls, VA 22066-2834 | 2019-04-14 |
| 1649733387 | Renaissance Medical Center | General Practice | 284 Blevins Blvd, Bristol, VA 24202-5977 | 2019-04-10 |
| 1174081707 | William Shannon | General Practice | 1751 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2019-03-02 |
| 1700367679 | Healthy Schools Virginia LLC | General Practice | 9603 Gayton Rd Ste 100, Richmond, VA 23238-4964 | 2018-08-28 |
| 1114414299 | Alliance Family Practice, Inc | General Practice | 119 W Brookland Park Blvd, Richmond, VA 23222-2633 | 2018-04-15 |
| Find all providers with the same taxonomy | ||||
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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.