Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mackenzie Noelle Tewksbury, PA-C

Individual provider Physician Assistant · NPI 1780484899

Mackenzie Noelle Tewksbury, PA-C is a Physician Assistant in Roanoke, Virginia. Qualified in 2025, 1 year ago. Works from 2 locations. Licensed in Virginia.

Years since qualifying
1
Licensed in
VA
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3 Riverside Cir
Roanoke, VA 24016-4955
Phone: (540) 224-5170
Fax: (540) 985-9427
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1906 Belleview Ave Se, Roanoke, VA 24014-1838 — (540) 981-7000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110011587 (VA)

Record details

NPI number1780484899
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 17, 2025
Last updated in NPPESMarch 13, 2026
Certification dateMarch 13, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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