Active NPI
William Broyles, MD
- Family Medicine Physician
- Kennesaw, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 84545
- Practice address
- 3805 Cherokee St NW
Kennesaw, GA 30144-2085 - Phone
- (770) 426-5665
- NPI assigned
- Oct 25, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 31453 | NC | |
| Family Medicine Physician | 207Q00000X | 84545 | GA | Primary |
Addresses
Primary practice location
3805 Cherokee St NW
Kennesaw, GA 30144-2085
Mailing address
3805 Cherokee St NW Ste D
Kennesaw, GA 30144-2085
Phone (770) 426-5665
Other practice location 1
2100 Erwin Rd
Duke Univ Med Center
Durham, NC 27710
Phone (919) 620-4467
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | wbroyles357216@directwellstar.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
120 Greystone Power Blvd
Dallas, GA 30157-8297
1550 Kennesaw Due W Rd NW
Kennesaw, GA 30152-4338
3747 Roswell Rd
Marietta, GA 30062-6227
3980 Jiles Rd NW
Kennesaw, GA 30144-1109
Phone (678) 504-0100
4477 Towne Lake Pkwy
Suite 130
Woodstock, GA 30189-6720
Phone (770) 249-5620
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
Hospital & facility affiliations
- Wellstar Kennestone Regional Medical Center
- Wellstar Cobb Medical Center
- Wellstar Windy Hill Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84545 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Family Medicine | Current | Accepting new patients |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients |
Locations
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
3805 Cherokee St NW
Kennesaw, GA 30144
Phone (770) 426-5665
3805 Cherokee St NW
Ste D
Kennesaw, GA 30144
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
-
- Hospice and Palliative Medicine (Family Medicine) Physician
- Austell, GA
- NPI 1942593959
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Austell, GA
- NPI 1467420448
-
- General Acute Care Hospital
- Marietta, GA
- NPI 1649248626
-
- Long Term Care Hospital
- Marietta, GA
- NPI 1700853041
Long-term care hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590105600000",
"number": "1700960424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3805 CHEROKEE ST NW STE D",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301442085",
"telephone_number": "770-426-5665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3805 CHEROKEE ST NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301442085",
"telephone_number": "770-426-5665"
}
],
"practiceLocations": [
{
"address_1": "2100 Erwin Rd",
"address_2": "Duke Univ Med Center",
"address_purpose": "LOCATION",
"city": "DURHAM",
"state": "NC",
"postal_code": "27710",
"country_code": "US",
"telephone_number": "919-620-4467",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROYLES",
"first_name": "WILLIAM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2020-05-22",
"certification_date": "2020-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "31453",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "84545",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "wbroyles357216@directwellstar.org",
"affiliation": "N",
"address_1": "3805 Cherokee St NW",
"city": "Kennesaw",
"state": "GA",
"country_code": "US",
"postal_code": "301442085",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; 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.