Lewis-Gale Physicians, LLC
Lewis-Gale Physicians, LLC is a healthcare organization registered as Family Medicine Physician in Roanoke, VA, holding Type 2 (organization) NPI 1063484921 since 2006. The authorized official on file is Otis Blackwood, Practice Administrator.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1063484921 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Lewis-Gale Physicians, LLC |
| Other name | <Unavail> |
| Practice address | 4910 VALLEY VIEW BLVD NW, Roanoke, VA, 24012 |
| Phone | 5402651607 |
| Fax | 5403667353 |
| Enumeration date | 2006-02-06 |
| Last updated in NPPES | 2025-09-11 |
Authorized official
| Name | Otis Blackwood |
|---|---|
| Title | Practice Administrator |
| Phone | 5407723671 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207N00000X | Dermatology Physician | Secondary | 0101040969 | VA |
| 207W00000X | Ophthalmology Physician | Secondary | 0101042126 | VA |
| 207Q00000X | Family Medicine Physician | Primary | 0101235727 | VA |
Copy-ready billing details
Provider: Lewis-Gale Physicians, LLC NPI: 1063484921 Taxonomy: 207Q00000X (Family Medicine Physician) Address: 4910 VALLEY VIEW BLVD NW, Roanoke, VA, 24012
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1164409652 | John Daugherty | Individual | Family Medicine Physician | Roanoke, VA |
| 1396724977 | David Keilman | Individual | Family Medicine Physician | Roanoke, VA |
| 1124007448 | Larry Patton | Individual | Dermatology Physician | Roanoke, VA |
| 1063488534 | Serge Depret-Guillaume | Individual | Family Medicine Physician | Roanoke, VA |
| 1588753065 | Angela Warnick | Individual | Pharmacist | Roanoke, VA |
| 1508934308 | Valley View Pharmacy Inc | Organization | Community/Retail Pharmacy | Roanoke, VA |
| 1861691552 | David Mortlock | Individual | Family Medicine Physician | Roanoke, VA |
| 1366698409 | Lavonne Pruitt | Individual | Family Nurse Practitioner | Roanoke, VA |
Verify this record
Cross-check NPI 1063484921 against the authoritative CMS record: view Lewis-Gale Physicians, LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Lewis-Gale Physicians, LLC?
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-09-11.