Carilion Giles Community Hospital
Organization Active NPI Rural Health Clinic/Center · Boones Mill, VA
NPI 1154948271 · NPPES record last updated Feb 27, 2026
Key facts
- NPI
- 1154948271
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- CARILION GILES COMMUNITY HOSPITAL
- Practice address
- 22890 Virgil Goode Hwy.
Boones Mill, VA 24065 - Phone
- (540) 334-5511
- NPI assigned
- Jul 6, 2020
- Organization subpart
- Yes
- Parent organization (as reported)
- CARILION GILES COMMUNITY HOSPITAL
Authorized official
- Name
- Eleanor Altman Prescott
- Title
- Director of Payer Contract Admin.
- Phone
- (540) 224-5379
Owners & managing parties with NPI records 3
-
Jose M Rivero, MD
Other NPIs on the same Medicare enrollment 14
Other NPIs with the same Medicare PAC ID 16
Corporate family (same tax ID) 16
Related certifications (CCN) 4
Change of ownership 1
Facilities with the same owner 31
Practitioners 232
-
Amy E Butler, MD
-
Stacie Adkins, D.O.
-
Vittario Allen, FNP-C
-
Carol Ann Ascher, NP
-
Paul M Barkovic Balbach, NP-C
-
Jaimie Nichole Ball, FNP-C
-
Timothy Beirne, MD
-
Mohammed Bermo, MD
-
Joseph Arlan Birkman, D.O.
-
Dustin M. Boatman, M.D.
-
Sonya N Bohon, MD
-
Osei A Bonsu, D.O.
-
John A Boone, DO
-
Junetta Nuckels Bowen, D.O.
-
Casey Rae Bowles, PA-C
-
Jacob Bowles, PA-C
-
Wayne Lee Brackenrich, D.O.
-
Linda Buchanan, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D0231693 | Carilion Clinic FM-Boones Mill | Certificate of waiver | May 17, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA
Rural health clinic certification: CCN 493443
- Legal name
- CARILION GILES COMMUNITY HOSPITAL
- Doing business as
- CARILION CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Sep 8, 2020
- Last certification
- Sep 8, 2020
- Ownership / control type
- 1B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 12, 1948 in VA
- Enrollment address
- 22890 Virgil Goode Hwy
Boones Mill, VA 24065-4989 - Related CCNs
- 491302
All disclosed owners & managing parties 23
| Name | Role | Since | Share |
|---|---|---|---|
| George Robert Vaughan |
Corporate Director |
Jan 1, 2010 | |
| Johnny Mills |
Corporate Director |
Oct 1, 2023 | |
| Kristi Eaton |
Corporate Officer |
Oct 1, 2025 | |
| Christopher Hansen |
Corporate Director | Sep 30, 2022 | |
| Kristie G Williams |
Corporate Director | Sep 30, 2022 | |
| Eleanor Prescott |
Corporate Director |
Oct 14, 2025 | |
| Richard McCoy |
Corporate Director | Sep 30, 2022 | |
| Christopher McKlarney |
Corporate Director | Sep 30, 2022 | |
| Andrew P Wagner |
Corporate Director | Sep 30, 2022 | |
| Joshua Hartle |
Corporate Director |
Oct 6, 2025 | |
| Donald B Halliwill |
Corporate Director |
Jan 1, 2010 | |
| Priscilla Morris |
Corporate Director | Sep 30, 2022 | |
| James a Hartley |
Corporate Director | Sep 30, 2022 | |
| Veronica Stump |
Corporate Director |
Oct 1, 2023 | |
| William J Flattery |
Corporate Director | Sep 30, 2022 | |
| Carilion Clinic |
5% Or Greater Direct Ownership Interest | Jul 1, 2005 | 80% |
| Jose M Rivero |
Corporate Director | Sep 30, 2022 | |
| Michael L Bailey |
Corporate Director | Sep 30, 2022 | |
| Melissa Stump |
Corporate Director | Sep 30, 2022 | |
| Senthil Marimuthu |
Corporate Director |
Oct 1, 2023 | |
| Michael a McMahon |
Corporate Director | Sep 30, 2022 | |
| Kimberly Reynolds |
W-2 Managing Employee | May 22, 2023 | |
| Richard C Jennell |
Corporate Director | Sep 30, 2022 |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Sep 8, 2020 | Change of Ownership |
Carilion Healthcare Corporation |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070516000487 | VA | Part B Supplier - Clinic/Group Practice | 3678670221 |
Receives reassigned benefits from 732 practitioners 14 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Middleburg, VA; Wytheville, VA; Virginia Beach, VA; Tazewell, VA; Rocky Mount, VA; Pearisburg, VA; Norfolk, VA; Martinsville, VA… |
| O20201204002543 | VA | Part a Provider - Rural Health Clinic | 3678670221 | Practice locations: Boones Mill, VA |
National Provider Directory
- Tax ID family
- Carilion Giles Mem Hosp
- Part of
- Carilion Giles Mem Hosp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
22890 Virgil Goode Hwy.
Boones Mill, VA 24065
Mailing address
213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5452
Other names
- Carilion Clinic Boones Mill RHC
- Carilion Clinic Family & Internal Medicine
Other providers in Boones Mill, VA
- Melanie Ausburne
- Christopher Lee Baugher
- Lisa Marie Belderes
- Carilion Healthcare Corporation
- Bristol Lowder Choquette
- Jennifer Cooper
- Family Preservation Services, Inc
- Emily Guill
All providers in Boones Mill, VA · Rural Health Clinic/Center in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.