NPIMap

Individual provider Active NPI

Caleb Donaldson Southall, MD

  • Family Medicine Physician
  • Sutherland, VA
National Provider Identifier
1285212480
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101283159 Issued in VA
Practice address
5609 Claiborne Rd
Sutherland, VA 23885-9303
Phone
(804) 265-5211
NPI assigned
Mar 30, 2021
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101283159 VA Primary

Addresses

Primary practice location

5609 Claiborne Rd
Sutherland, VA 23885-9303

Mailing address

13540 Hull Street Rd
Midlothian, VA 23112-2107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241001004470 VA Practitioner - Family Practice 5698206605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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 IncGroup PAC ID 1153309703, 3 clinicians

Practice addresses (Care Compare)

5609 Claiborne Rd
Sutherland, VA 23885-9303
Phone (804) 265-5211

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101283159VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutherland Family Practice Inc. Family Medicine CurrentSince Aug 22, 2024 Accepting new patients

Locations

5609 Claiborne Rd
Sutherland, VA 23885
Phone (804) 265-5211

Interoperability endpoints

  • Direct secure messaging: caleb.southall.1@27068.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/27068/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

Hospital & facility affiliations 8

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": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1285212480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13540 HULL STREET RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5609 CLAIBORNE RD",
            "city": "SUTHERLAND",
            "state": "VA",
            "postal_code": "238859303",
            "telephone_number": "804-265-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHALL",
        "first_name": "CALEB",
        "middle_name": "DONALDSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101283159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sutherland, VA

Sources for this page

Verify at the official NPI Registry.