Individual provider Active NPI

Charles Clay Branscom, DO

  • Internal Medicine Physician
  • Roanoke, VA
National Provider Identifier
1376239335
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0102209931 Issued in VA
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone
(540) 981-7000
Fax
(540) 853-0931
NPI assigned
Apr 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 0102209931 VA Primary

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5516

Other practice location 1

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230628003594 NC Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3476912189

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

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

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: cbranscom448176@directhisp.wakemed.org

NPI Registry JSON

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1376239335",
    "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",
            "telephone_number": "540-224-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-7000",
            "fax_number": "540-853-0931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 New Bern Ave",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276101231",
            "country_code": "US",
            "telephone_number": "919-350-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANSCOM",
        "first_name": "CHARLES",
        "middle_name": "CLAY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-13",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102209931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.