NPIMap

Individual provider Active NPI

Valenica Eggleston-Clark, MD

  • Family Medicine Physician
  • Martinsville, VA
National Provider Identifier
1316069933
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101243377 Issued in VA
Practice address
1107A Brookdale St
Martinsville, VA 24112-4501
Phone
(276) 670-3300
Fax
(276) 634-0379
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 129166 NC
Family Medicine Physician 207Q00000X 0101243377 VA Primary

Addresses

Primary practice location

1107A Brookdale St
Martinsville, VA 24112-4501

Mailing address

1107A Brookdale St
Martinsville, VA 24112-4501
Phone (276) 670-3300

Other identifiers 1

IdentifierTypeStateIssuer
1316069933MedicaidVA

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
I20080710000586 VA Practitioner - Family Practice 3375615131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Giles Community HospitalGroup PAC ID 3678670221, 223 clinicians
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians
Oandw EnterprisesGroup PAC ID 6608927298, 216 clinicians

Practice addresses (Care Compare)

1107 A Brookdale St
Martinsville, VA 24112-4501
Phone (276) 670-3300

1906 Belleview Ave SE
Roanoke, VA 24014-1838

6415 Peters Creek Rd
Roanoke, VA 24019-4021
Phone (703) 562-2110

935 Fairystone Park Hwy
Stanleytown, VA 24168-3014
Phone (888) 724-0268

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129166NCMDFamily Medicine Physician
0101243377VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Jul 21, 2008 Accepting new patients
Carilion Giles Community Hospital CurrentSince Aug 1, 2020 Accepting new patients
Carilion Giles Community Hospital CurrentSince Aug 1, 2020 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jul 21, 2008 Accepting new patients

Locations

1107A Brookdale St
Martinsville, VA 24112
Phone (276) 634-0379

1107 Brookdale St
Martinsville, VA 24112
Phone (276) 634-0005

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

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

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

Interoperability endpoints

  • Direct secure messaging: vegglestonclark22834@direct.carilionclinic.org

Organizations & group practices 5

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 10

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1316069933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107A BROOKDALE ST",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241124501",
            "telephone_number": "276-670-3300",
            "fax_number": "276-634-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107A BROOKDALE ST",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241124501",
            "telephone_number": "276-670-3300",
            "fax_number": "276-634-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGGLESTON-CLARK",
        "first_name": "VALENICA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "129166",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101243377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316069933",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsville, VA

Sources for this page

Verify at the official NPI Registry.