Individual provider Active NPI

Kelley Lynn Busam, FNP-C

  • Family Nurse Practitioner
  • Lexington, VA
National Provider Identifier
1336902113
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024189328 Issued in VA
Practice address
110 Houston St Ste D
Lexington, VA 24450-2437
Phone
(540) 462-3950
NPI assigned
Feb 5, 2024
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024189328 VA Primary

Addresses

Primary practice location

110 Houston St Ste D
Lexington, VA 24450-2437

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other practice location 1

131 Dor Rie Ln
Providence, NC 27315-9613
Phone (434) 203-0255

Other names 1

  • Kelley Lynn Doss Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240411000124 VA Practitioner - Nurse Practitioner 4981042843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Emergency Services IncGroup PAC ID 7012820889, 67 clinicians

Practice addresses (Care Compare)

110 Houston St
Suite D
Lexington, VA 24450-2437
Phone (540) 591-9456

434 Peppers Ferry NW Rd
Christiansburg, VA 24073-5780
Phone (540) 382-6000

46 Wesley Rd
Daleville, VA 24083-3082
Phone (540) 591-9440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024189328VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Emergency Services, Inc. CurrentSince Oct 6, 2025 Accepting new patients
Carilion Healthcare Corporation CurrentSince Oct 6, 2025 Accepting new patients
Carilion Healthcare Corporation CurrentSince Oct 6, 2025 Accepting new patients

Locations

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

110 Houston St
Ste D
Lexington, VA 24450
Phone (540) 462-3950

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

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

Interoperability endpoints

  • Direct secure messaging: kdoss76527@direct.carilionclinic.org

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1336902113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HOUSTON ST STE D",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244502437",
            "telephone_number": "540-462-3950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 Dor Rie Ln",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "NC",
            "postal_code": "273159613",
            "country_code": "US",
            "telephone_number": "434-203-0255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSAM",
        "first_name": "KELLEY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024189328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "DOSS",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, VA

Sources for this page

Verify at the official NPI Registry.