Caleb Donaldson Southall, MD
Individual provider Active NPI Family Medicine Physician · Sutherland, VA
NPI 1285212480 · NPPES record last updated Oct 18, 2024
Key facts
- NPI
- 1285212480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0101283159 (VA)
- Practice address
- 5609 Claiborne Rd
Sutherland, VA 23885-9303 - Phone
- (804) 265-5211
- NPI assigned
- Mar 30, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Virginia School of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sutherland Family Practice Inc
Practice addresses (Care Compare)
5609 Claiborne Rd
Sutherland, VA 23885-9303
Phone (804) 265-5211
Hospital & facility affiliations
- Amedisys Home Health
- Bon Secours Southside Medical Center
- John Randolph Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241001004470 | VA | Practitioner - Family Practice | 5698206605 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutherland Family Practice Inc. | Family Medicine | Current |
Accepting new patients |
Locations
5609 Claiborne Rd
Sutherland, VA 23885
Phone (804) 265-5211
Interoperability endpoints
- https://api.platform.athenahealth.com/27068/brand/1/csg/1/fhir/r4
- caleb.southall.1@27068.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101283159 | VA | Yes |
Addresses
Primary practice location
5609 Claiborne Rd
Sutherland, VA 23885-9303
Mailing address
13540 Hull Street Rd
Midlothian, VA 23112-2107
Other providers in Sutherland, VA
- Happy Home Counseling Services, LLC
- Heath A Marshall
- Parker Family Services
- Sarah Parker
- William James Phipps Jr.
- Kirby D Southall
- Sutherland Family Practice Inc.
- Sutherland Pharmacy,Inc
All providers in Sutherland, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.