Individual provider Active NPI

Kevin E Broyles, D.O.

  • Emergency Medicine Physician
  • Roanoke, VA
National Provider Identifier
1073555348
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0102201510 Issued in VA
Practice address
1906 Belleview Ave SE
Emergency Dept
Roanoke, VA 24014-1838
Phone
(540) 981-7000
Fax
(540) 981-9550
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0102201510 VA Primary

Addresses

Primary practice location

1906 Belleview Ave SE
Emergency Dept
Roanoke, VA 24014-1838

Mailing address

PO Box 2080
Kilmarnock, VA 22482-2080
Phone (804) 435-3508

Other identifiers 3

IdentifierTypeStateIssuer
010045924MedicaidVA
010048729MedicaidVA
010045932MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040323001018 VA Practitioner - Emergency Medicine 7315838927 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
West Virginia School of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, shared by 11 NPIs, 956 clinicians

Practice addresses (Care Compare)

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

Hospital & facility affiliations

  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0102201510VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Nov 28, 2010 Accepting new patients
Carilion Giles Community Hospital CurrentSince Sep 14, 2019 Accepting new patients
Carilion Rockbridge Community Hospital CurrentSince Jun 1, 2025 Accepting new patients
Carilion Emergency Services, Inc. CurrentSince Dec 1, 2003 Accepting new patients
Carilion Medical Center CurrentSince Jan 1, 2009 Accepting new patients
Carilion Medical Center Emergency Medicine CurrentSince Jan 1, 2009 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jun 1, 2025 Accepting new patients
Carilion Giles Community Hospital CurrentSince Sep 14, 2019 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jun 1, 2025 Accepting new patients

Locations

434 Peppers Fry Rd NW
Christiansburg, VA 24073
Phone (540) 382-6000

1 Health Cir
Lexington, VA 24450
Phone (540) 458-3300

159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

Interoperability endpoints

  • Direct secure messaging: kbroyles13406@direct.carilionclinic.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1073555348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2080",
            "city": "KILMARNOCK",
            "state": "VA",
            "postal_code": "224822080",
            "telephone_number": "804-435-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "address_2": "EMERGENCY DEPT",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-7000",
            "fax_number": "540-981-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROYLES",
        "first_name": "KEVIN",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102201510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010045924",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010048729",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010045932",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.