Carilion Healthcare Corporation

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

CARILION HEALTHCARE CORPORATION

Doing business as

Carilion Clinic Family & Internal Medicine

Practice address

22890 Virgil H Goode Highway
Boones Mill, VA 24065

Phone

(540) 334-5511

NPI assigned

Jun 19, 2020

Last updated

May 25, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

CARILION HEALTHCARE CORPORATIONAs reported in NPPES

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

Authorized official

Name

Nicole Grisetti

Title

Director of Operational Support

Phone

(540) 224-5352

Specialties & licenses 1

Addresses

Other names 1

• Carilion Clinic Family & Internal Medicine Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

CFM Family Practice Cli

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Carilion Giles Community Hospital

  dba Carilion Clinic Boones Mill RHC

  • Rural Health Clinic/Center
  • Boones Mill, VA
  • NPI 1154948271

  Sold to, 2020-09-08

  CMS change of ownership

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1760008387",
    "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": "540-224-5250",
            "fax_number": "540-224-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22890 VIRGIL H GOODE HIGHWAY",
            "city": "BOONES MILL",
            "state": "VA",
            "postal_code": "24065",
            "telephone_number": "540-334-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARILION HEALTHCARE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARILION HEALTHCARE CORPORATION",
        "enumeration_date": "2020-06-19",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "GRISETTI",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONAL SUPPORT",
        "authorized_official_telephone_number": "540-224-5352"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carilion Clinic Family & Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carilion Clinic Family & Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melanie Ausburne, LMT, LPN
• Christopher Lee Baugher, LPTA
• Lisa Marie Belderes, PT
• Carilion Giles Community Hospital (Carilion Clinic Boones Mill RHC)
• Bristol Lowder Choquette, CCC-SLP
• Jennifer Cooper
• Family Preservation Services, Inc
• Emily Guill, MS,CCC-SLP
• Anita Gurganious

• Rural Health Clinic/Center in Boones Mill, VA
• Providers in Boones Mill, VA by specialty
• Rural Health Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.