Clarence Edward Hall II, M.D.
Individual provider Active NPI Family Medicine Physician · Crewe, VA
NPI 1487730362 · NPPES record last updated Aug 26, 2008
Key facts
- NPI
- 1487730362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0101102561 (VA)
- Practice address
- 12522 W. Colonial Trail Hwy.
Crewe, VA 23930 - Phone
- (434) 645-9191
- Fax
- (434) 645-1859
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 22
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
12522 W Colonial Trail Hwy
Crewe, VA 23930-3329
Phone (434) 645-9191
Hospital & facility affiliations
- Amedisys Home Health
- James River Home Health Care LLC
- Centra Home Health
- Southside Community Hospital, Inc
- CJW Medical Center
- Bon Secours St Francis Medical Center
- Community Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 48 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
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: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080620000084 | VA | Practitioner - Family Practice | 4082785969 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101102561 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crewe Medical Center Inc | Family Medicine | Current |
Accepting new patients |
| Crewe Medical Center | Family Medicine | Past | Accepting new patients |
| CMH ER Physicians, LLC | Past | Accepting new patients |
Locations
12522 W Colonial Trail Hwy
Crewe, VA 23930
Phone (434) 645-9191
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CFFEBA
- https://fhir4.healow.com/fhir/r4/CFFEBA/Endpoint/CFFEBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101102561 | VA | Yes |
Addresses
Primary practice location
12522 W. Colonial Trail Hwy.
Crewe, VA 23930
Mailing address
PO Box 528
12522 W. Colonial Trail Hwy.
Crewe, VA 23930-0528
Phone (434) 645-9191
Other providers in Crewe, VA
- Family Preservation Services, Inc
- Family Preservation Services, Inc
- John E Gehman Sr.
- Jackie Alicia Green-August
- Chioma Adaku Griffin
- Avante Mone Hawkes
- House Calls M.D.
- Housecalls MD
- Kimberlynn'S Company, LLC
- Venugopal Mateti
All providers in Crewe, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2008. 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.