Active NPI
Diana P Crowder, PAC
- Medical Physician Assistant
- South Hill, VA
National Provider Identifier
1174524516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0110001616
- Practice address
- 1755 N Mecklenburg Ave
South Hill, VA 23970-4080 - Phone
- (434) 447-3151
- Fax
- (434) 584-5023
- NPI assigned
- Aug 9, 2005
- Last updated
- Jul 1, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0110001616 | VA | Primary |
Addresses
Primary practice location
1755 N Mecklenburg Ave
South Hill, VA 23970-4080
Mailing address
PO Box 91734
Richmond, VA 23291-1734
Phone (804) 358-6100
Other practice location 1
412 Durant St
South Hill Internal Medicine Critical Care
South Hill, VA 23970-1614
Phone (434) 447-2898
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010117852 | Medicaid | VA |
Other names 1
- Ms. Mary Diana Phillips
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1755 N Mecklenburg Ave
South Hill, VA 23970-4080
Phone (434) 447-3151
401 N 11TH St
Richmond, VA 23219-1901
Phone (804) 828-9000
401 N 11TH St
Richmond, VA 23219-1914
Phone (804) 828-8737
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.74 of 100
- Quality
- 74.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.96
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.95 of 100
- Quality
- 69.91
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 77.42
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110001616 | VA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Hill Internal Medicine and Critical Care P.C. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- South Hill, VA
- NPI 1194760645
-
- Legal Medicine
- South Hill, VA
- NPI 1740363027
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- South Hill, VA
- NPI 1336103738
-
dba Medical College of Virginia Hospitals
- General Acute Care Hospital
- Richmond, VA
- NPI 1013091727
-
dba VCU Medical Center
- General Acute Care Hospital
- Richmond, VA
- NPI 1437175734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1174524516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 91734",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232911734",
"telephone_number": "804-358-6100",
"fax_number": "804-342-7619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1755 N MECKLENBURG AVE",
"city": "SOUTH HILL",
"state": "VA",
"postal_code": "239704080",
"telephone_number": "434-447-3151",
"fax_number": "434-584-5023"
}
],
"practiceLocations": [
{
"address_1": "412 Durant St",
"address_2": "South Hill Internal Medicine Critical Care",
"address_purpose": "LOCATION",
"city": "South Hill",
"state": "VA",
"postal_code": "239701614",
"country_code": "US",
"telephone_number": "434-447-2898",
"fax_number": "434-447-3456",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CROWDER",
"first_name": "DIANA",
"middle_name": "P",
"name_prefix": "Mrs.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-09",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "VA",
"license": "0110001616",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010117852",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "PHILLIPS",
"middle_name": "DIANA",
"prefix": "MS.",
"credential": "PAC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in South Hill, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.
- 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.