NPIMap

Organization Active NPI

Brea Roanoke LLC

Doing business as Brookdale Roanoke

  • Assisted Living Facility
  • Roanoke, VA
National Provider Identifier
1831426717
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
BREA ROANOKE LLC
Doing business as
Brookdale Roanoke
Practice address
1127 Persinger Rd SW
Roanoke, VA 24015-3829
Phone
(540) 343-4900
Fax
(540) 343-4900
NPI assigned
Nov 12, 2009
Last updated
Mar 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Anna F.C. Munoz
Title
Assistant Secretary
Phone
(414) 918-5443

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary
Alzheimer Center (Dementia Center) 311500000X RO-08-179 VA

Addresses

Primary practice location

1127 Persinger Rd SW
Roanoke, VA 24015-3829

Mailing address

1127 Persinger Rd SW
Roanoke, VA 24015-3829
Phone (540) 343-4900

Other names 1

  • Brookdale Roanoke Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2025469Brookdale Roanoke1127 Persinger Road, Roanoke, VA 24015Certificate of waiverJun 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Brea Palmer Ranch LLC25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1831426717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 PERSINGER RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240153829",
            "telephone_number": "540-343-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 PERSINGER RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240153829",
            "telephone_number": "540-343-4900",
            "fax_number": "540-343-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREA ROANOKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-12",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "MUNOZ",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "F.C.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "414-918-5443"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "VA",
            "license": "RO-08-179",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Roanoke",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.