Healthcare Provider Details

I. General information

NPI: 1083518088
Provider Name (Legal Business Name): DR. ALEXIS BAADER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEXI BAADER DC

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 SUMMERS WAY STE 103
ROANOKE VA
24019-8455
US

IV. Provider business mailing address

PO BOX 25
BLUE RIDGE VA
24064-0025
US

V. Phone/Fax

Practice location:
  • Phone: 540-966-1423
  • Fax:
Mailing address:
  • Phone: 540-966-1423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104558203
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: