Bart L Eastwood (NPI# 1720142508, PAC ID# 3274633201) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1720142508 |
| PAC ID by PECOS | 3274633201 |
| Professional Enrollment ID | I20150926000214 |
| Full Name | Bart L Eastwood |
| Organization Legal Name | SIDELINE ORTHOPEDICS AND SPORTS MEDICINE LLC |
| Address |
250 S Main St Suite 224a Blacksburg VA 24060-4725 |
| Phone Number | 5405527133 |
| Gender | M |
| Graduation Year | 2002 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 3072801612 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490110 | LEWISGALE HOSPITAL MONTGOMERY |
| 490116 | LEWISGALE HOSPITAL PULASKI |
| 490042 | CARILION NEW RIVER VALLEY MEDICAL CENTER |
| 490111 | WYTHE COUNTY COMMUNITY HOSPITAL |
| 491302 | CARILION GILES COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1000 Vermillion St, Athens, WV 24712-9027 | 5405527133 | SIDELINE ORTHOPEDICS AND SPORTS MEDICINE LLC |
| 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 | 5405527133 | SIDELINE ORTHOPEDICS AND SPORTS MEDICINE LLC |
| Organization Legal Name | SIDELINE ORTHOPEDICS AND SPORTS MEDICINE LLC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jordan Nelson Gibson | Physical Therapy | Sideline Orthopedics and Sports Medicine LLC | 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 |
| Derek S Buck | Physical Medicine and Rehabilitation | Sideline Orthopedics and Sports Medicine LLC | 111 Sanders Ln, Bluefield, VA 24605-9278 |
| Kayla Danielle Owata | Physical Therapy | Sideline Orthopedics and Sports Medicine LLC | 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 |
| Elizabeth Denton Ashe | Physician Assistant | Sideline Orthopedics and Sports Medicine LLC | 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 |
| Matthew Scott Shortt | Physician Assistant | Sideline Orthopedics and Sports Medicine LLC | 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 |
| Street Address |
250 S MAIN ST SUITE 224A |
| City | BLACKSBURG |
| State | VA |
| Zip | 24060-4725 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jordan Nelson Gibson | Physical Therapy | Sideline Orthopedics and Sports Medicine LLC | 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 |
| Kayla Danielle Owata | Physical Therapy | Sideline Orthopedics and Sports Medicine LLC | 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 |
| Kathleen Walworth | Physical Therapy | Farmington Physical Therapy Inc | 250 S Main St, Suite 4, Brooklyn, MI 49230-9114 |
| Elizabeth Denton Ashe | Physician Assistant | Sideline Orthopedics and Sports Medicine LLC | 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 |
| Matthew Scott Shortt | Physician Assistant | Sideline Orthopedics and Sports Medicine LLC | 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gwendolyn W Spangler | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Kristopher Joel Hansen | Hematology/oncology | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Michele Lee Keesling | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Charlene M Jordan | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Amy Ratcliffe Butler | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Heather L Bayless | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Mazen I Madhoun | Family Medicine | 3400 Southpoint Dr, Blacksburg, VA 24060-1261 | |
| Glenda Beekmann Ball | Nurse Practitioner | Family Medicine of Blacksburg, LLC | 1645 N Main St, Blacksburg, VA 24060-2554 |
| Avery M Matthews | Psychiatry | Family Medicine of Blacksburg, LLC | 1645 N Main St, Blacksburg, VA 24060-2554 |
| Lynn M Bever | Psychologist, Clinical | 1501 Lark Ln, Blacksburg, VA 24060-2658 | |
| Find all physicians in zip 24060 | |||
| City | BLACKSBURG |
| Zip Code | 24060 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | BLACKSBURG + ORTHOPEDIC SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.