Individual provider Active NPI

Kayla Trevillian, DNP, FNP-C

  • Family Nurse Practitioner
  • Roanoke, VA
National Provider Identifier
1386427060
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024187835 Issued in VA
Practice address
4910 Valley View Blvd NW
Roanoke, VA 24012-2040
Phone
(540) 362-0360
NPI assigned
Aug 16, 2023
Last updated
Sep 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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 0024187835 VA Primary

Addresses

Primary practice location

4910 Valley View Blvd NW
Roanoke, VA 24012-2040

Mailing address

5060 Valley View Blvd NW
Roanoke, VA 24012-2038
Phone (540) 595-9525

Other practice location 1

3716 Melrose Ave NW
Roanoke, VA 24017-2716
Phone (540) 362-0360

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
I20231121002379 VA Practitioner - Nurse Practitioner 8123476793 Reassigns benefits to 1 organization

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

Practice addresses (Care Compare)

3716 Melrose Ave NW
Roanoke, VA 24017-2716
Phone (540) 362-0360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kuumba Community Health & Wellness Center, Inc. CurrentSince Sep 12, 2023 Accepting new patients
Kuumba Community Health & Wellness Center, Inc. CurrentSince Sep 12, 2023 Accepting new patients

Locations

3716 Melrose Ave NW
Roanoke, VA 24017
Phone (540) 362-0360

5060 Valley View Blvd NW
Roanoke, VA 24012
Phone (540) 278-1051

Organizations & group practices 2

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": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1386427060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 VALLEY VIEW BLVD NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240122038",
            "telephone_number": "540-595-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 VALLEY VIEW BLVD NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240122040",
            "telephone_number": "540-362-0360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3716 Melrose Ave NW",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240172716",
            "country_code": "US",
            "telephone_number": "540-362-0360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TREVILLIAN",
        "first_name": "KAYLA",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024187835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.