Active NPI
Charles Clay Branscom, DO
- Internal Medicine Physician
- Roanoke, VA
National Provider Identifier
1376239335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0102209931
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230628003594 | NC | Order and Referring Only - 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
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.