Damon R. Broyles, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2004002145 Issued in MO

Practice address

701 S New Ballas Rd Ste 150
Saint Louis, MO 63141-8728

Phone

(636) 237-4025

Fax

(636) 237-4030

NPI assigned

Jul 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO, AR2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  Medicare reassignment NPD
• Mercy Aco Clinical Services Inc

  • Neurology Physician
  • Chesterfield, MO
  • NPI 1063965093
  Medicare reassignment
• Mercy Health Northwest Arkansas Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Rogers, AR
  • NPI 1699016774
  NPD
• Mercy Health Northwest Arkansas Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Rogers, AR
  • NPI 1770087371
  NPD

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1407856396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S NEW BALLAS RD STE 150",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418728",
            "telephone_number": "636-237-4025",
            "fax_number": "636-237-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S NEW BALLAS RD STE 150",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418728",
            "telephone_number": "636-237-4025",
            "fax_number": "636-237-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROYLES",
        "first_name": "DAMON",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2004002145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208987800",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebekah Lee Browning, MD PHD
• Angela K Brownlee, CNA
• Kimberly L Brownridge, MA, LPC, NCC
• Violet Kryzsko Brownsmith, MD
• Jane E Brownstone, PHD
• Beverly S Brozanski, MD
• Laura Brozka
• Hope Brubaker
• Margaret Rachel Brubaker, MD
• Bruce Cook Prosthetics

• Family Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.