Sarah Jacklyn Fletcher Broyles, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110002406 Issued in VA

Practice address

10279 Hurley Rd
Hurley, VA 24620

Phone

(276) 566-7204

Fax

(276) 546-9710

NPI assigned

Aug 24, 2006

Last updated

Jun 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Charles Health Council Inc

  dba Thompson Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Vansant, VA
  • NPI 1801013354
  Medicare reassignment
• St Charles Health Council Inc

  dba Hurley Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Hurley, VA
  • NPI 1801060595
  NPD
• St Charles Health Council Inc

  dba Coeburn Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Coeburn, VA
  • NPI 1942322003
  NPD
• Joshua P Sutherland Jr PC

  • Family Medicine Physician
  • Grundy, VA
  • NPI 1528282241
  NPD (past)
• Riverside Medical Clinic Inc

  • Family Nurse Practitioner
  • Grundy, VA
  • NPI 1508263088
  NPD (past)
• St. Charles Health Council, Inc

  dba Stone Mountain Health Services Pharmacy

  • Pharmacy
  • Ewing, VA
  • NPI 1275594095
  NPD (past)
• The Woman's Group Richlands

  • Obstetrics & Gynecology Physician
  • Richlands, VA
  • NPI 1154541159
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1881701092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10279 HURLEY RD",
            "city": "HURLEY",
            "state": "VA",
            "postal_code": "24620",
            "telephone_number": "276-566-7204",
            "fax_number": "276-546-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10279 HURLEY RD",
            "city": "HURLEY",
            "state": "VA",
            "postal_code": "24620",
            "telephone_number": "276-566-7204",
            "fax_number": "276-546-9710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2951 W. Front Street",
            "address_2": "Suite 2900",
            "address_purpose": "LOCATION",
            "city": "Richlands",
            "state": "VA",
            "postal_code": "24641",
            "country_code": "US",
            "telephone_number": "276-596-9660",
            "fax_number": "276-596-9149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROYLES",
        "first_name": "SARAH",
        "middle_name": "JACKLYN FLETCHER",
        "name_prefix": "Mrs.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bailey & Ramey Enterprises (Hurley Community Pharmacy)
• Family Preservation Services, Inc
• Knox Creek Volunteer Fire Department
• Mounts Medical Transportation Inc
• Joseph Mounts, MEDICAL TAXI OWNER
• Kaitlyn Mullins, FNP-C

• Physician Assistant in Hurley, VA
• Providers in Hurley, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.