Individual provider Active NPI

Anthony William Baffoe-Bonnie, M.D.

  • Infectious Disease Physician
  • Roanoke, VA
National Provider Identifier
1386680304
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
0101252104 Issued in VA
Practice address
2001 Crystal Spring Ave SW
Roanoke, VA 24014-2462
Phone
(540) 981-7715
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11599 NV
Infectious Disease Physician 207RI0200X 0101252104 VA Primary

Addresses

Primary practice location

2001 Crystal Spring Ave SW
Roanoke, VA 24014-2462

Mailing address

2001 Crystal Spring Ave SW
Roanoke, VA 24014-2462
Phone (540) 981-7715

Other identifiers 1

IdentifierTypeStateIssuer
100509428MedicaidNV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abaffoebonnie5328@direct.carilionclinic.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130807000597 VA Practitioner - Infectious Disease 1052329406 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11599NVMDInternal Medicine Physician
0101252104VAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Jul 15, 2013 Accepting new patients
Carilion Medical Center CurrentSince Jul 15, 2013 Accepting new patients
Carilion Giles Community Hospital CurrentSince May 21, 2022 Accepting new patients
Carilion Giles Community Hospital CurrentSince May 21, 2022 Accepting new patients
Nikos Inpatient Services Internal Medicine Past Accepting new patients
Overton Urgent Care Internal Medicine Past Accepting new patients
Rabessler MD PC Internal Medicine Past Accepting new patients
Northern Nevada Medical Group, LLC Internal Medicine Past Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000

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

2001 Crystal Spring Ave SW
Roanoke, VA 24014
Phone (540) 344-5781

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

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

Interoperability endpoints

  • Direct secure messaging: abaffoebonnie5328@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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1386680304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 CRYSTAL SPRING AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142462",
            "telephone_number": "540-981-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 CRYSTAL SPRING AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142462",
            "telephone_number": "540-981-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAFFOE-BONNIE",
        "first_name": "ANTHONY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "11599",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "VA",
            "license": "0101252104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100509428",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abaffoebonnie5328@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "abaffoebonnie5328@direct.carilionclinic.org",
            "address_1": "2001 Crystal Spring Ave SW",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240142462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.