FIRST LIGHT CLINIC LLC (NPI# 1851924088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851924088 |
| Entity Type | Organization |
| Organization Name | FIRST LIGHT CLINIC LLC |
| Practice Address |
706 Campbell Ave Sw Roanoke VA 24016-3534 |
| Practice Telephone | 5404007841 |
| Practice Fax Number | 5404008177 |
| Mailing Telephone | 5404007841 |
| Mailing Fax Number | 5404008177 |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-02-17 |
| Authorized Official Name | KELLEY BURNETTE (OFFICE MANAGER) |
| Authorized Official Telephone | 5404007841 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
706 CAMPBELL AVE SW |
| City | ROANOKE |
| State | VA |
| Zip Code | 24016-3534 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1700070083 | Long Sight, PC | Clinic/Center | 22 Campbell Ave Se, Roanoke, VA 24011-1404 | 2007-08-30 |
| 1134333990 | Tlc Vc, LLC | Clinic/Center | 3800 Electric Rd, Ste. 307, Roanoke, VA 24018-4569 | 2007-05-10 |
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| 1720639503 | Javan Wellness Ballston LLC | Clinic/Center | 4000 Wilson Blvd Ste D, Arlington, VA 22203-4401 | 2019-09-24 |
| 1144879206 | Neurological Clinic, Sc | Clinic/Center | 7700 Little River Tpke Ste 605, Annandale, VA 22003-2400 | 2019-09-10 |
| 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.