Colton Ryan Thames, FNP
Individual provider Active NPI Family Nurse Practitioner · Clarksville, VA
NPI 1285304097 · NPPES record last updated Dec 6, 2021
Key facts
- NPI
- 1285304097
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0024182554 (VA)
- Practice address
- 115 College St
Clarksville, VA 23927-9125 - Phone
- (434) 374-5344
- NPI assigned
- Sep 14, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Vanderbilt University School of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Halifax Regional Hospital Inc
Practice addresses (Care Compare)
115 College St
Clarksville, VA 23927-9125
Phone (434) 374-5344
Hospital & facility affiliations
- Amedisys Home Health
- 1St Care Home Health South Boston
- Sentara Home Care Services (Halifax)
- Sentara Halifax Regional Hospital
- Community Memorial Hospital
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220228001883 | VA | Practitioner - Nurse Practitioner | 1355735895 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Halifax Regional Hospital, Inc | Current |
Accepting new patients | |
| Halifax Regional Hospital, Inc. | Current |
Accepting new patients | |
| Halifax Regional Hospital, Inc | Past | Accepting new patients |
Locations
115 College St
Clarksville, VA 23927
Phone (434) 374-5344
2204 Wilborn Ave
South Boston, VA 24592
Phone (434) 517-3100
Interoperability endpoints
- cthames674618@direct.sentara.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024182554 | VA | Yes |
Addresses
Primary practice location
115 College St
Clarksville, VA 23927-9125
Mailing address
115 College St
Clarksville, VA 23927-9125
Phone (434) 374-5344
Other providers in Clarksville, VA
- Alicia Devon Small
- Southside Behavioral Health
- Intekhab Askari Syed Ahmad Raza
- Chelsey Marie Tanner
- Ashley Mae Terry
- Victoria Tyler
- Virginia CVS Pharmacy LLC
- Vivia Brogden Whitfield
- Alisha Michelle Wright
- Reginald S Young
All providers in Clarksville, VA · Family Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2021. 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.