Willoughby Shelton Hundley III, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0101034527 Issued in VA

Practice address

969 Madison Street
Suite/Box 297
Boydton, VA 23917

Phone

(434) 738-6911

Fax

(434) 738-0431

NPI assigned

Mar 6, 2006

Last updated

May 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency MedicineAlso: Family Practice

Education

Virginia Commonwealth University, School of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vidant Roanoke Chowan Hospital Hospital, Ahoskie, NC, CCN 340099

Merit-based Incentive Payment System (MIPS)

Final score

96.95 of 100Reported as apm

Quality

82.44

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment Care Compare group NPD
• Alexandria Springfield Emergency Physicians PC

  • Emergency Medicine Physician
  • Franklin, VA
  • NPI 1740529700
  Medicare reassignment NPD
• Emergency Medicine Associates, P.a.,P.C.

  • Internal Medicine Physician
  • Dulles, VA
  • NPI 1376917070
  Medicare reassignment NPD
• Emergency Coverage, LLC

  dba Emergency Coverage Corporation of TeamHealth

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  Emergency Medicine, VA

  Medicare reassignment NPD
• Mecklenburg Family Practice

  • Primary Care Clinic/Center
  • Boydton, VA
  • NPI 1427232735

  Family Medicine

  NPD Authorized official
• Alexandria Springfield Emergency Physicians PC

  • Emergency Medicine Physician
  • Alexandria, VA
  • NPI 1720839764
  NPD
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD
• Vidant Medical Group LLC

  dba Vidant Endoscopy Center-Kinston

  • Ambulatory Surgical Clinic/Center
  • Kinston, NC
  • NPI 1376049619
  NPD
• Community Memorial Healthcenter

  dba Clarksville Primary Care Center

  • Rural Health Clinic/Center
  • Clarksville, VA
  • NPI 1487736864
  NPD (past)
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593
  NPD (past)
• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• East Carolina Health

  dba ECU Health Roanoke-Chowan Hospital

  • General Acute Care Hospital
  • Ahoskie, NC
  • NPI 1467441394
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1457328767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 297",
            "city": "BOYDTON",
            "state": "VA",
            "postal_code": "239170297",
            "telephone_number": "434-738-6911",
            "fax_number": "434-738-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 MADISON STREET",
            "address_2": "SUITE/BOX 297",
            "city": "BOYDTON",
            "state": "VA",
            "postal_code": "23917",
            "telephone_number": "434-738-6911",
            "fax_number": "434-738-0431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "349 Madison St",
            "address_purpose": "LOCATION",
            "city": "Boydton",
            "state": "VA",
            "postal_code": "23917",
            "country_code": "US",
            "telephone_number": "434-738-8359",
            "fax_number": "804-482-2499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUNDLEY",
        "first_name": "WILLOUGHBY",
        "middle_name": "SHELTON",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-06",
        "last_updated": "2024-05-03",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101034527",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "9801679",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9801679",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101034527",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David William Eason, DDS
• Efficient Transportation Services
• Marie Goodwin, MSN FNP-C
• Carolyn Shores Hoyle, APRN/ FNP-C
• Jan L Hundley, CNS
• Robin H. Jennings, RDH
• Journey to Peace, LLC
• KLM Pediatric Therapy Services
• Carolyn B Leach, NP
• T'Onna Logan

• Emergency Medicine Physician in Boydton, VA
• Providers in Boydton, VA by specialty
• Emergency Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.

Verify at the official NPI Registry.