Performance Medicine of Southwest Virginia, LLC – Family Medicine Physician, NPI 1679905467

Performance Medicine of Southwest Virginia, LLC is a healthcare provider. based in Roanoke, Virginia. specializing in Family Medicine Physician. The NPI Number for Performance Medicine of Southwest Virginia, LLC is 1679905467

Main info

Organization
Name
Performance Medicine of Southwest Virginia, LLC
NPI
1679905467
Phone
(540) 345-3556
Address
PO BOX 8310
Authorized Official
DELMAS J BOLIN PRESIDENT M.D.
Enumeration Date
2 August 2013
Last Update Date
23 May 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness80
Years active:12State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Performance Medicine of Southwest Virginia, LLC

  • PO BOX 8310

    ROANOKE, VA 240140310

    Phone: (540) 345-3556

    Fax: (540) 342-2193

    Type: Mailing

  • 25 W CALHOUN ST

    SALEM, VA 241533836

    Phone: (540) 772-1890

    Fax: (540) 772-1893

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-09-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-08-31 (1014 days ago).

Enrollment records

1

Earliest due date

2023-08-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20130916000007OClinic/Group PracticeVA2023-08-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 24014)

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Reviews

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Frequently asked questions

Can I use this page to confirm Performance Medicine of Southwest Virginia, LLC's NPI?
Yes. Performance Medicine of Southwest Virginia, LLC is listed with NPI 1679905467 in the public NPI dataset.
Can I rely on Performance Medicine of Southwest Virginia, LLC being an active provider?
As of the registry snapshot, Performance Medicine of Southwest Virginia, LLC is marked active.
What healthcare role does Performance Medicine of Southwest Virginia, LLC hold?
Scheduling teams often label Performance Medicine of Southwest Virginia, LLC under Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Performance Medicine of Southwest Virginia, LLC?
Performance Medicine of Southwest Virginia, LLC's geographic hint is Roanoke, Virginia in our summary view.
Why does Performance Medicine of Southwest Virginia, LLC have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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