Healthcare Provider Details

I. General information

NPI: 1053015669
Provider Name (Legal Business Name): CHIPLEY JONES CLARKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHIPLEY ELIZABETH BADER

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 HEALTH CAMPUS DR
ROCKINGHAM VA
22801-8679
US

IV. Provider business mailing address

1906 BELLEVIEW AVE SE
ROANOKE VA
24014-1838
US

V. Phone/Fax

Practice location:
  • Phone: 540-689-1110
  • Fax:
Mailing address:
  • Phone: 540-981-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0102209880
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0102209880
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: