Active NPI 1568441046 Individual Practitioner Female Practitioner

Dr. Susan Kinnison , MD

Surgery • Roanoke, VA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Susan Kinnison, MD is a certified Surgery practicing in Roanoke, VA. With approximately 32 years of clinical experience since graduating from Northeastern Ohio University College Of Medicine in 1994, Dr. Kinnison delivers high-quality medical care to the local community at 101 ELM AVE SE.

Dr. Kinnison maintains professional affiliations with Vohra Wound Physicians Of Fl Llc, Balance Wellspace Integrative Medicine Inc, Blue Ridge Wound Care Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least, subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least, removal of skin and tissue, 20.0 sq cm or less. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

101 Elm Ave Se

Roanoke, VA 240132222

Telephone 5402244325

Associated Practice Facility / Clinic

🏢 Carilion Medical Center Facility NPI 1730302126

Medicare Profile & Education

Medical School

Northeastern Ohio University College Of Medicine

Graduation Year

1994

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Roanoke, VA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

32 Yrs +8.3 yrs vs City Avg

City Avg: 23.7 Yrs

State Avg: 24.6 Yrs

Regional Practice Density

47 Specialists

Practicing in Roanoke, VA (909 Statewide)

Telehealth Adoption Rate

19.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

46.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Kinnison (32 Years) 32 Yrs

Roanoke Specialty Average (23.7 Years) 23.7 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	306	88	$135.49	$103.21
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	231	61	$109.22	$71.30
11042 Removal of skin and tissue, 20.0 sq cm or less	138	48	$257.93	$55.77
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	106	22	$443.11	$140.21
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	105	32	$128.95	$102.88
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	86	25	$102.21	$71.03
11042 Removal of skin and tissue, 20.0 sq cm or less	60	16	$239.75	$122.42
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	59	12	$154.92	$73.49
17250 Application of chemical to stop tissue regrowth in wound	57	16	$172.81	$34.98
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	57	43	$75.35	$38.59
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	46	44	$155.22	$128.07
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	31	15	$300.00	$122.38
99306 Initial nursing facility visit, typically 45 minutes per day	28	26	$203.75	$175.03
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	21	15	$187.86	$147.43
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	19	14	$69.74	$38.44
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	17	17	$152.65	$127.79

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	354	124	$170.31	$73.86
11042 Removal of skin and tissue, 20.0 sq cm or less	236	74	$329.39	$124.80
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	178	90	$236.38	$105.91
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	175	38	$573.17	$229.73
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	149	77	$159.13	$73.86
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	120	35	$555.68	$151.69
11042 Removal of skin and tissue, 20.0 sq cm or less	102	52	$329.19	$54.85
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	89	22	$174.22	$75.72
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	81	53	$208.06	$105.91
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	49	49	$182.32	$79.92
17250 Application of chemical to stop tissue regrowth in wound	43	21	$226.07	$70.74
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	41	13	$299.26	$126.65
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	40	32	$92.60	$39.37
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	40	40	$184.80	$79.92
99306 Initial nursing facility visit, typically 45 minutes per day	31	31	$412.93	$180.88
43762 Replacement of stomach stoma tube	27	12	$631.01	$217.15
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	25	17	$362.88	$152.22
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	21	21	$235.24	$132.34
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	13	13	$261.35	$132.34
99306 Initial nursing facility visit, typically 45 minutes per day	12	12	$427.62	$180.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	500	169	$164.76	$68.78
11042 Removal of skin and tissue, 20.0 sq cm or less	481	115	$339.66	$117.12
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	448	69	$600.90	$235.20
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	433	140	$215.06	$90.62
17250 Application of chemical to stop tissue regrowth in wound	294	65	$239.76	$65.66
11042 Removal of skin and tissue, 20.0 sq cm or less	175	67	$339.66	$52.77
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	100	38	$600.90	$153.00
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	97	65	$164.76	$68.76
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	94	16	$193.60	$74.98
17250 Application of chemical to stop tissue regrowth in wound	86	27	$239.76	$21.63
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	70	12	$193.60	$56.01
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	70	70	$211.56	$88.76
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	62	62	$211.56	$88.86
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	54	39	$215.06	$90.78
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	49	14	$106.70	$41.74
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	43	25	$318.44	$133.39
11044 Removal of bone, 20.0 sq cm or less	39	11	$799.78	$318.08
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	39	39	$304.74	$128.44
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	20	20	$304.74	$128.45
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	20	14	$318.44	$133.86
99306 Initial nursing facility visit, typically 45 minutes per day	20	20	$392.04	$165.07
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	15	12	$103.86	$43.62
99306 Initial nursing facility visit, typically 45 minutes per day	12	12	$392.04	$164.87

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	1,070	299	$164.93	$69.35
11042 Removal of skin and tissue, 20.0 sq cm or less	857	207	$340.00	$113.21
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	678	103	$601.62	$238.38
17250 Application of chemical to stop tissue regrowth in wound	517	111	$240.03	$64.78
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	349	174	$215.32	$91.46
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	306	135	$164.84	$69.35
11042 Removal of skin and tissue, 20.0 sq cm or less	279	119	$340.13	$54.53
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	159	35	$194.17	$75.61
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	148	54	$601.99	$156.51
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	132	37	$106.93	$42.22
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	119	24	$193.85	$56.67
17250 Application of chemical to stop tissue regrowth in wound	93	45	$240.94	$24.31
11044 Removal of bone, 20.0 sq cm or less	85	19	$800.60	$319.82
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	83	83	$211.95	$90.05
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	83	28	$106.70	$26.78
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	79	59	$215.29	$91.45
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	77	77	$305.03	$130.01
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	68	68	$211.80	$90.04
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	62	48	$319.99	$135.65
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	43	43	$305.25	$130.01
99306 Initial nursing facility visit, typically 45 minutes per day	32	32	$392.04	$167.17
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	29	21	$103.86	$44.16
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	21	16	$318.44	$135.65
99306 Initial nursing facility visit, typically 45 minutes per day	19	19	$392.04	$167.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	460	141	$324.19	$113.41
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	446	173	$164.37	$70.53
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	382	142	$216.50	$92.80
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	317	69	$586.86	$234.75
11042 Removal of skin and tissue, 20.0 sq cm or less	236	102	$324.16	$52.25
17250 Application of chemical to stop tissue regrowth in wound	226	69	$222.81	$63.69
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	171	59	$586.55	$157.91
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	125	73	$164.26	$70.30
17250 Application of chemical to stop tissue regrowth in wound	102	44	$222.74	$24.47
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	95	64	$216.78	$92.45
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	80	51	$317.92	$137.39
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	69	18	$190.12	$75.57
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	67	67	$305.30	$131.70
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	65	18	$190.02	$57.94
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	63	28	$106.14	$42.59
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	62	20	$106.17	$27.43
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	50	50	$304.10	$131.83
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	45	45	$213.86	$92.06
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	42	42	$218.95	$91.88
11044 Removal of bone, 20.0 sq cm or less	40	13	$792.14	$323.20
G0406 Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth	28	14	$100.34	$39.26
G0407 Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth	24	14	$184.20	$72.50
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	20	15	$104.12	$44.57

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	564	170	$309.60	$113.12
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	549	201	$161.10	$69.07
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	432	166	$213.92	$92.01
11042 Removal of skin and tissue, 20.0 sq cm or less	272	116	$309.60	$56.17
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	222	66	$565.36	$230.73
17250 Application of chemical to stop tissue regrowth in wound	165	56	$210.80	$67.10
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	163	53	$565.36	$156.69
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	149	29	$181.74	$74.16
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	142	88	$161.10	$69.19
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	130	80	$213.92	$92.01
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	118	39	$102.04	$41.90
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	88	17	$181.74	$57.13
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	83	83	$210.16	$90.61
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	78	22	$102.04	$26.99
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	60	60	$210.16	$90.62
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	53	53	$302.98	$130.94
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	40	29	$105.46	$44.24
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	39	39	$302.98	$130.94
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	22	14	$315.96	$136.27
17250 Application of chemical to stop tissue regrowth in wound	20	18	$210.80	$26.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	781	166	$298.52	$109.46
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	466	190	$162.88	$68.82
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	420	154	$214.60	$90.95
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	283	73	$560.62	$227.57
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	187	27	$101.95	$41.24
11042 Removal of skin and tissue, 20.0 sq cm or less	173	78	$298.52	$56.39
17250 Application of chemical to stop tissue regrowth in wound	110	45	$208.62	$54.58
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	104	24	$181.54	$73.01
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	100	41	$560.62	$156.44
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	92	19	$181.54	$56.59
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	74	47	$104.52	$44.25
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	71	16	$101.95	$26.57
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	51	36	$162.88	$68.81
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	47	47	$303.72	$129.63
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	45	45	$212.72	$90.65
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	36	29	$214.60	$90.93
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	35	35	$212.72	$90.63
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	31	31	$303.72	$129.72
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	21	17	$318.34	$135.28

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	652	145	$282.45	$102.23
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	488	179	$156.39	$65.95
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	328	88	$541.77	$215.74
17250 Application of chemical to stop tissue regrowth in wound	216	78	$196.53	$67.29
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	179	107	$205.95	$87.27
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	164	36	$174.78	$70.18
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	126	34	$90.16	$39.04
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	100	52	$101.35	$42.62
11042 Removal of skin and tissue, 20.0 sq cm or less	89	47	$259.51	$50.66
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	76	33	$529.03	$148.79
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	74	14	$177.26	$54.35
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	66	37	$146.46	$65.99
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	41	12	$78.64	$25.23
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	33	33	$297.89	$124.52
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	32	32	$196.54	$87.28
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	28	28	$297.11	$124.52
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	28	28	$208.70	$87.28
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	16	14	$201.20	$87.54

Medical Specialties & State Licenses

CMS Verified: 2020-08-06

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License VA 0101227973

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Family Medicine

NUCC Taxonomy Code: 207Q00000X

State License VA 0101227973

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

007313535 (VA)

Medicaid State Provider ID

1568441046 (VA)

Commercial Insurance / Payer ID Medicare Railroad

P00310524 (VA)

Hospital & Practice Group Affiliations

Vohra Wound Physicians Of Fl Llc

3900 Westerre Pkwy, Richmond, VA 232331478

Phone: 9543994673

Vohra Wound Physicians Of Fl Llc

1000 Fairview Ave, Clifton Forge, VA 244221873

Phone: 5408634096

Blue Ridge Wound Care Llc

2522 Colonial Ave Sw, Roanoke, VA 240153121

Phone: 5408882792

Balance Wellspace Integrative Medicine Inc

2522 Colonial Ave Sw, Roanoke, VA 240153121

Phone: 5403430055

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners

Dr. Robert Knowles , MD

Surgery

NPI 1013915602

Doctor of Medicine (M.D.)

Dr. Young Kang , MD

Plastic Surgery

NPI 1053387308

Doctor of Medicine (M.D.)

Dr. Kimberly Thomas , DNP, RN, CNS

Clinical Nurse Specialist

NPI 1619399631

Doctor of Nursing Practice, Registered Nurse, Clinical Nurse Specialist

Allison Workman , PA

Physician Assistant

NPI 1780128389

Physician Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location August 06, 2020

Registered at 101 ELM AVE SE, ROANOKE, VA 240132222 (Tel: 5402244325)

📍

Updated Business Mailing Address August 06, 2020

Registered at 213 S JEFFERSON ST STE 625, ROANOKE, VA 240111713 (Tel: 5402245679)

✅

NPI Profile Active April 06, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location April 06, 2016

Registered at 3601 SW 160TH AVE, SUITE 250, MIRAMAR, FL 330276308 (Tel: 8778667123)

📍

Updated Business Mailing Address April 06, 2016

Registered at 1 ARH LANE, SUITE 202B, LOW MOOR, VA 24457 (Tel: 5408627181)

👤

Provider Name / Credentials Updated April 06, 2016

Recorded as SUSAN KINNISON, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 06, 2016

Family Medicine (License #0101227973 in VA)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 06, 2016

Surgery (License #0101227973 in VA)

🟢

Initial NPI Registration & Enumeration January 12, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1568441046

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: January 12, 2006

Last Update: August 06, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

213 S Jefferson St Ste 625

Roanoke, VA 240111713

Phone: 5402245679

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.