Individual provider Active NPI

Anthony Staples

  • Neurology with Special Qualifications in Child Neurology Physician
  • Roanoke, VA
National Provider Identifier
1255727145
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
0102206585 Issued in VA
Practice address
4348 Electric Rd
Roanoke, VA 24018-0720
Phone
(540) 769-0976
Fax
(540) 857-5392
NPI assigned
Apr 8, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2187 AL
Pediatric Sleep Medicine Physician 2080S0012X 2187 AL
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 2187 AL
Student in an Organized Health Care Education/Training Program 390200000X
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 0102206585 VA Primary

Addresses

Primary practice location

4348 Electric Rd
Roanoke, VA 24018-0720

Mailing address

213 S Jefferson St
Roanoke, VA 24011-1705

Other practice location 1

1600 7th Ave S
Birmingham, AL 35233-1711
Phone (205) 975-9925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200826003897 AL Practitioner - NeurologyPractitioner - Pediatric MedicinePractitioner - Sleep Medicine 4486071131 Reassigns benefits to 1 organization
I20211011000347 VA Practitioner - Pediatric Medicine 4486071131 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102206585VAMDNeurology with Special Qualifications in Child Neurology Physician
2187ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Rockbridge Community Hospital CurrentSince Apr 22, 2024 Accepting new patients
Carilion Healthcare Corporation CurrentSince Apr 22, 2024 Accepting new patients
Carilion Medical Center CurrentSince Aug 30, 2021 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Jul 1, 2020 Accepting new patients
Carilion Healthcare Corporation CurrentSince Apr 22, 2024 Accepting new patients
University of Alabama Health Services Foundation, PC Pediatrics CurrentSince Jul 1, 2020 Accepting new patients
Carilion Medical Center CurrentSince Aug 30, 2021 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

1600 7th Ave S
Birmingham, AL 35233
Phone (205) 638-9100

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

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

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

4348 Electric Rd
Roanoke, VA 24018
Phone (540) 769-0600

213 S Jefferson St
Roanoke, VA 24011

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

102 Highland Ave SE
Ste 104
Roanoke, VA 24013
Phone (540) 343-4423

Interoperability endpoints

  • Direct secure messaging: astaples306832@direct.ccf.org
  • Direct secure messaging: astaples135459@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.

NPI Registry JSON

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1255727145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4348 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180720",
            "telephone_number": "540-769-0976",
            "fax_number": "540-857-5392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 7th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331711",
            "country_code": "US",
            "telephone_number": "205-975-9925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-08",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "2187",
            "primary": false
        },
        {
            "code": "2080S0012X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sleep Medicine",
            "state": "AL",
            "license": "2187",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "AL",
            "license": "2187",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "VA",
            "license": "0102206585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.