ILANA NICOLE KELLOGG WAASDORP (NPI# 1720425549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720425549 |
| Entity Type | Individual |
| Full Name | ILANA NICOLE KELLOGG WAASDORP |
| Credential | PT, DPT |
| Practice Address |
1421 3rd St Sw Roanoke VA 24016-5204 |
| Practice Telephone | 3039003457 |
| Mailing Telephone | 3039003457 |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2020-01-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | PTL.0012174 | CO | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
2305212941 | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1421 3RD ST SW |
| City | ROANOKE |
| State | VA |
| Zip Code | 24016-5204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982692323 | Professional Therapies of Roanoke, Inc. | Clinic/Center | 1421 3rd St Sw, Roanoke, VA 24016-5204 | 2005-10-10 |
| 1275148983 | Victoria Thomas | Speech-Language Pathologist | 1421 3rd St Sw, Roanoke, VA 24016-5204 | 2020-09-09 |
| 1154939197 | Courtney Alissa Pinkard | Occupational Therapist | 1421 3rd St Sw, Roanoke, VA 24016-5204 | 2020-07-15 |
| 1083170823 | Nicole Frey | Occupational Therapist | 1421 3rd St Sw, Roanoke, VA 24016-5204 | 2019-02-18 |
| 1760959381 | Kelly Marie Athaide | Occupational Therapist | 1421 3rd St Sw, Roanoke, VA 24016-5204 | 2018-11-01 |
| 1760973754 | Jacob Dulski | Physical Therapist | 1421 3rd St Sw, Roanoke, VA 24016-5204 | 2018-05-24 |
| 1568974772 | Anna M. Morales | Occupational Therapy Assistant | 1421 3rd St Sw, Roanoke, VA 24016-5204 | 2017-10-27 |
| 1851800833 | Kelsey A. Yoder | Occupational Therapist | 1421 3rd St Sw, Roanoke, VA 24016-5204 | 2017-09-22 |
| 1013435247 | Neelesh N. Shah | Physical Therapy Assistant | 1421 3rd St Sw, Roanoke, VA 24016-5204 | 2017-09-08 |
| 1336667419 | Tyler R Kelly | Physical Therapy Assistant | 1421 3rd St Sw, Roanoke, VA 24016-5204 | 2017-09-08 |
| 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 | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427555796 | Kim Tong | Physical Therapist | 1756 Halifax St, Roanoke, TX 76262-1388 | 2018-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790334175 | Elizabeth Huff | Physical Therapist | 601 S Carlin Springs Rd Ste 505, Arlington, VA 22204-1044 | 2019-09-09 |
| 1851946503 | Courtney E Marin | Physical Therapist | 2235 Tacketts Mill Dr Bldg C, Woodbridge, VA 22192-3036 | 2019-08-08 |
| 1912475419 | Kelly Laughlin | Physical Therapist | 3544 36th Rd N, Arlington, VA 22207-4817 | 2018-11-02 |
| 1336622257 | Progressive Pediatric Therapy | Physical Therapist | 150 S. Washington St., #203, Falls Church, VA 22124 | 2018-09-07 |
| 1013413699 | Melissa Anne Casey | Physical Therapist | 778 Springsbury Rd, Berryville, VA 22611-1513 | 2018-04-03 |
| 1316443336 | Rhea Amber Whitlock | Physical Therapist | 615 East St, Blackstone, VA 23824-2231 | 2018-03-30 |
| 1821507062 | Jennifer Lewis | Physical Therapist | 6856 Richmond Highway, Alexandria, VA 22306 | 2017-09-20 |
| 1144758889 | Kristen Michelle Mcbee | Physical Therapist | 2781 Jefferson Davis Hwy, Stafford, VA 22554-8322 | 2017-05-25 |
| 1316313588 | Elizabeth Anne Brewer | Physical Therapist | 23 Curle Road, Hampton, VA 23669 | 2015-08-11 |
| 1912300377 | Kiley Coleman Gibbs | Physical Therapist | 21631 Ridgetop Cir Ste 225a, Sterling, VA 20166 | 2014-09-30 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ILANA NICOLE KELLOGG WAASDORP.
| 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.