WILLIAM WELLBORN (NPI# 1467432450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467432450 |
| Entity Type | Individual |
| Full Name | WILLIAM WELLBORN |
| Credential | PHD |
| Practice Address |
3 Riverside Cir Roanoke VA 24016-4955 |
| Mailing Address |
2825 Jefferson St Sw Roanoke VA 24014-3319 |
| Practice Telephone | 5405261364 |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2018-10-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810-002556 | VA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 7709129 | 05 |
| Street Address |
3 RIVERSIDE CIR |
| City | ROANOKE |
| State | VA |
| Zip Code | 24016-4955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376535872 | Bruce E Johnson | Internal Medicine | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2005-08-19 |
| 1194355024 | Leanna M Stone | Social Worker | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2020-01-20 |
| 1689231847 | Ashley Light | Audiologist | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2019-05-23 |
| 1063975282 | Katherine Elizabeth Chafin | Nurse Practitioner | 3 Riverside Cir, Roanoke, VA 24016 | 2019-04-14 |
| 1932665544 | Amy Marshall | Nurse Practitioner | 3 Riverside Cir, Roanoke, VA 24016 | 2019-02-19 |
| 1730652991 | Sydney Elizabeth Garst | Physician Assistant | 3 Riverside Cir, Roanoke, VA 24016 | 2019-01-09 |
| 1306318084 | Sarah Abey | Nurse Practitioner | 3 Riverside Cir, Roanoke, VA 24016 | 2018-12-19 |
| 1518439397 | Justin James Gray | Clinical Neuropsychologist | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2018-12-18 |
| 1992281877 | Corinne O'shaughnessy | Audiologist | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2018-07-13 |
| 1518453463 | Feryal Nauman | Student in an Organized Health Care Education/Training Program | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2018-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134758329 | Davis Andrew Sugar | Student in an Organized Health Care Education/Training Program | 1 Riverside Circle, Suite 401, Roanoke, Va, 24016, Suite 401, Roanoke, VA 24016 | 2020-04-08 |
| 1356810659 | Susanne Tribble | Social Worker | 202 Wells Ave Nw, Roanoke, VA 24016 | 2018-11-15 |
| 1801305818 | Rena Lee Daye | Driver | 10 12th St. Sw, Roanoke, VA 24016 | 2017-09-21 |
| 1053841965 | Christin Elledge Clark | Nurse Practitioner | 1234 Franklin Road, Roanoke, VA 24016 | 2017-06-13 |
| 1235685884 | Helen Franck | Physical Therapist | 650 North Jefferson Street, Roanoke, VA 24016 | 2016-09-01 |
| 1457710238 | Frances Marie Gaeta | Social Worker | 360 Campbell Ave, Roanoke, VA 24016 | 2016-02-22 |
| 1982073292 | Sophie Mench Tranmer | Physical Therapist | 1421 Third St. Sw, Roanoke, VA 24016 | 2015-09-16 |
| 1982008181 | National Counseling Group, Inc | Psychiatry & Neurology | 20 Walnut Avenue, Roanoke, VA 24016 | 2014-10-17 |
| 1366858342 | National Counseling Group, Inc | Psychiatry & Neurology | 16 Walnut Avenue, Roanoke, VA 24016 | 2014-07-10 |
| 1427320878 | Kristen L. Jagger | Physical Medicine & Rehabilitation | 1015 First Street Sw Suite 2, Roanoke, VA 24016 | 2012-02-01 |
| Find all providers in zip 24016 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851917843 | Nathaniel Andrew | Psychologist | 3112 Honeywood Ln Apt E, Roanoke, VA 24018-8853 | 2020-06-25 |
| 1245624196 | Andrea Miller | Psychologist | 30 Franklin Rd Sw, Suite 602, Roanoke, VA 24011-2423 | 2015-03-27 |
| 1306104005 | Brian L Lewis | Psychologist | 1317 3rd St Sw, Roanoke, VA 24016-5238 | 2012-05-01 |
| 1831376755 | Laura Janet Ely | Psychologist | 1402 Grandin Rd Sw Ste 211, Roanoke, VA 24015-2348 | 2008-01-22 |
| 1598884702 | Wee Leung Lee | Psychologist | 5427 Peters Creek Rd, Suite 100, Roanoke, VA 24019-3858 | 2007-03-28 |
| 1861518037 | Donald Joseph Gieck | Psychologist | 2017 S Jefferson St, Roanoke, VA 24014 | 2007-03-21 |
| 1861570822 | Paul Joseph Woods | Psychologist | 5541 Florist Rd, Roanoke, VA 24012-1233 | 2006-11-01 |
| 1356440184 | Debra A. Marks | Psychologist | 221 Albemarle Ave Sw, Roanoke, VA 24016-4716 | 2006-09-21 |
| 1972513893 | Montenique Finney | Psychologist | 4800 Pleasant Hill Dr, Ste 202, Roanoke, VA 24018-3406 | 2006-08-09 |
| 1326090580 | Louis Anthony Perrott | Psychologist | 3635 Manassas Dr, Roanoke, VA 24018-4031 | 2006-05-16 |
| Find all providers in ROANOKE | ||||
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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.