Individual provider Active NPI

Kyle Andrew Prickett, M.D.

  • Dermatology Physician
  • Roanoke, VA
National Provider Identifier
1942591375
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101259772 Issued in VA
Practice address
1 Riverside Cir Ste 300
Roanoke, VA 24016-4962
Phone
(540) 581-0170
Fax
(540) 344-2180
NPI assigned
Apr 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0101259772 VA Primary

Addresses

Primary practice location

1 Riverside Cir Ste 300
Roanoke, VA 24016-4962

Mailing address

1 Riverside Cir Ste 300
Roanoke, VA 24016-4962
Phone (540) 581-0170

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kprickett84226@direct.carilionclinic.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160826000526 VA Practitioner - Dermatology 5395053052 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Maryland School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Practice addresses (Care Compare)

1 Riverside Cir
Roanoke, VA 24016-4962
Phone (540) 224-5170

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

2901 Lamb Cir
Christiansburg, VA 24073-6347
Phone (540) 639-5888

Hospital & facility affiliations

  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024
  • Carilion Franklin Memorial Hospital Hospital, Rocky Mount, VA, CCN 490089

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision94
Removal of skin lesions20
Removal of skin cancer618
Removal of nail tissue1-10
Skin biopsy84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101259772VAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Giles Community Hospital CurrentSince Jul 17, 2023 Accepting new patients
Carilion Franklin Memorial Hospital CurrentSince Jul 17, 2023 Accepting new patients
Carilion Medical Center CurrentSince Aug 15, 2016 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jul 17, 2023 Accepting new patients
Carilion Tazewell Community Hospital CurrentSince Jul 17, 2023 Accepting new patients
Carilion Franklin Memorial Hospital CurrentSince Jul 17, 2023 Accepting new patients
Carilion Giles Community Hospital CurrentSince Jul 17, 2023 Accepting new patients
Carilion Medical Center CurrentSince Aug 15, 2016 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jul 17, 2023 Accepting new patients
Carilion Rockbridge Community Hospital CurrentSince Jul 17, 2023 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

2901 Lamb Cir
Christiansburg, VA 24073
Phone (540) 639-5888

1 Health Cir
Lexington, VA 24450
Phone (540) 458-3300

159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000

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

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

1 Riverside Cir
Ste 300
Roanoke, VA 24016
Phone (540) 581-0180

1204 Franklin Rd SW
Roanoke, VA 24016
Phone (540) 345-6010

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

180 Floyd Ave
Rocky Mount, VA 24151
Phone (540) 483-5277

388 Ben Bolt Ave
Tazewell, VA 24651
Phone (276) 988-2506

Organizations & group practices 11

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1942591375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RIVERSIDE CIR STE 300",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164962",
            "telephone_number": "540-581-0170",
            "fax_number": "540-344-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RIVERSIDE CIR STE 300",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164962",
            "telephone_number": "540-581-0170",
            "fax_number": "540-344-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICKETT",
        "first_name": "KYLE",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101259772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kprickett84226@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kprickett84226@direct.carilionclinic.org",
            "address_1": "1 Riverside Cir Ste 300",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240164962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.