NPIMap

Individual provider Active NPI

Clinton Hale Sutherland, MD

  • Internal Medicine Physician
  • Abingdon, VA
National Provider Identifier
1487622320
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101049088 Issued in VA
Practice address
391 Falls Dr NW
Abingdon, VA 24210-8093
Phone
(276) 628-4406
Fax
(276) 628-4906
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101049088 VA Primary

Addresses

Primary practice location

391 Falls Dr NW
Abingdon, VA 24210-8093

Mailing address

105 W Stone Dr
Suite 6a
Kingsport, TN 37660-3365
Phone (423) 408-7220

Other identifiers 1

IdentifierTypeStateIssuer
006076661MedicaidVA

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
I20100727001072 VA Practitioner - Internal Medicine 4981737970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
JC Edwards School of Medicine, Marshall University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

1990 Holton Ave E
Big Stone Gap, VA 24219-3350
Phone (423) 230-8200

603 Campus Dr
Suite 100
Abingdon, VA 24210-9700
Phone (276) 628-4406

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Abingdon, VA, CCN 497566
  • Adoration Home Health Home health agency, Wise, VA, CCN 497288
  • Special Care Home Health Home health agency, Grundy, VA, CCN 497602
  • Buchanan General Hospital Home Health Agency Home health agency, Grundy, VA, CCN 497020
  • Russell County Hospital Hospital, Lebanon, VA, CCN 490002
  • Johnston Memorial Hospital Hospital, Abingdon, VA, CCN 490053
  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
  • Buchanan General Hospital Hospital, Grundy, VA, CCN 490127
  • Clinch Valley Medical Center Hospital, Richlands, VA, CCN 490060

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101049088VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates Inc CurrentSince Jul 1, 2012 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Wellmont Physician Services Inc Internal Medicine Past Accepting new patients
Blue Ridge Medical Management Corporation Past Accepting new patients

Locations

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

391 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-4406

603 Campus Dr
#100
Abingdon, VA 24210
Phone (276) 628-4406

1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111

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 9

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1487622320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "SUITE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 FALLS DR NW",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242108093",
            "telephone_number": "276-628-4406",
            "fax_number": "276-628-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "CLINTON",
        "middle_name": "HALE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101049088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006076661",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

Verify at the official NPI Registry.