NPIMap

Individual provider Active NPI

Clarence Edward Hall II, M.D.

  • Family Medicine Physician
  • Crewe, VA
National Provider Identifier
1487730362
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101102561 Issued in VA
Practice address
12522 W. Colonial Trail Hwy.
Crewe, VA 23930
Phone
(434) 645-9191
Fax
(434) 645-1859
NPI assigned
Oct 31, 2006
Last updated
Aug 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101102561 VA Primary

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

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
I20080620000084 VA Practitioner - Family Practice 4082785969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions48
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101102561VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crewe Medical Center Inc Family Medicine CurrentSince Jan 2, 2008 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

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFFEBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CFFEBA/Endpoint/CFFEBA

Organizations & group practices 3

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.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1487730362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 528",
            "address_2": "12522 W. COLONIAL TRAIL HWY.",
            "city": "CREWE",
            "state": "VA",
            "postal_code": "239300528",
            "telephone_number": "434-645-9191",
            "fax_number": "434-645-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12522 W. COLONIAL TRAIL HWY.",
            "city": "CREWE",
            "state": "VA",
            "postal_code": "23930",
            "telephone_number": "434-645-9191",
            "fax_number": "434-645-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "CLARENCE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101102561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crewe, VA

Sources for this page

Verify at the official NPI Registry.