Individual provider Active NPI

Bradley Ward Williams, PA-C

  • Physician Assistant
  • Roanoke, VA
National Provider Identifier
1851379655
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110840740 Issued in VA
Practice address
2331 Franklin Rd SW
Roanoke, VA 24014-1111
Phone
(540) 725-1226
Fax
(540) 857-5306
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0110840740 VA
Physician Assistant 363A00000X 0110840740 VA Primary

Addresses

Primary practice location

2331 Franklin Rd SW
Roanoke, VA 24014-1111

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5715

Other identifiers 10

IdentifierTypeStateIssuer
371194700OtherVABLACK LUNG
540506332108OtherVATRICARE/CHAMPUS
1851379655OtherVAOPTIMA HEALTH PLAN
1851379655OtherVAINTOTAL
1851379655OtherVAAETNA
1851379655OtherVASOUTHERN HEALTH/CARENET/CARELINK/COVENTRY
1851379655OtherVAANTHEM MEDIGAP
1851679655OtherVAHUMANA MEDICARE
1851379655MedicaidVA
P00831117OtherVARAILROAD MEDICARE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040325000295 VA Practitioner - Physician Assistant 6406748664 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians
Carilion Emergency Services IncGroup PAC ID 7012820889, 67 clinicians

Practice addresses (Care Compare)

4035 Electric Rd
Roanoke, VA 24018-8449

434 Peppers Ferry NW Rd
Christiansburg, VA 24073-5780
Phone (540) 382-6000

6415 Peters Creek Rd
Roanoke, VA 24019-4021
Phone (703) 562-2110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110840740VAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Apr 1, 2010 Accepting new patients
Carilion Healthcare Corporation CurrentSince Aug 20, 2018 Accepting new patients
Carilion Healthcare Corporation CurrentSince Aug 20, 2018 Accepting new patients
Carilion Emergency Services, Inc. CurrentSince Sep 26, 2022 Accepting new patients
Carilion Medical Center CurrentSince Apr 1, 2010 Accepting new patients

Locations

434 Peppers Fry Rd NW
Christiansburg, VA 24073
Phone (540) 382-6000

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

1102 S Jefferson St
Roanoke, VA 24016
Phone (540) 342-0707

2331 Franklin Rd SW
Roanoke, VA 24014
Phone (540) 725-1226

4064 Postal Dr
Roanoke, VA 24018
Phone (540) 776-0200

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

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

2001 Crystal Spring Ave SW
Ste 201
Roanoke, VA 24014
Phone (540) 853-0100

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

Interoperability endpoints

  • Direct secure messaging: bwilliams6216@direct.carilionclinic.org

Organizations & group practices 5

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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1851379655",
    "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": "540-224-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141111",
            "telephone_number": "540-725-1226",
            "fax_number": "540-857-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRADLEY",
        "middle_name": "WARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110840740",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110840740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "371194700",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "540506332108",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH PLAN",
            "identifier": "1851379655",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTOTAL",
            "identifier": "1851379655",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1851379655",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH/CARENET/CARELINK/COVENTRY",
            "identifier": "1851379655",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM MEDIGAP",
            "identifier": "1851379655",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA MEDICARE",
            "identifier": "1851679655",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851379655",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00831117",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.