Individual provider Active NPI

Carl Robert Hannah, M.D

  • Family Medicine Physician
  • Christiansburg, VA
National Provider Identifier
1700848363
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101235860 Issued in VA
Practice address
6 Hickok St
Christiansburg, VA 24073-3524
Phone
(540) 383-6148
Fax
(540) 382-4191
NPI assigned
Apr 6, 2006
Last updated
Jan 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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 0101235860 VA Primary

Addresses

Primary practice location

6 Hickok St
Christiansburg, VA 24073-3524

Mailing address

6 Hickok St
Christiansburg, VA 24073-3524
Phone (540) 383-6148

Other identifiers 10

IdentifierTypeStateIssuer
010098891OtherVAVIRGINIA PREMIER
3131709OtherVAMAMSI PROVIDER NUMBER
245710OtherVASOUTHERN HEALTH PROVIDER
144661OtherVAANTHEM PROVIDER NUMBER
2065534OtherVAUNITED HEALTHCARE
5389156OtherVAAETNA PROVIDER NUMBER
P00240702OtherVIMEDICARE RAILROAD
010098891MedicaidVA
1700848363MedicaidVA
7161454OtherVACIGNA PROVIDER NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CARL.HANNAH@hca6.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20041028001137 VA Practitioner - Family PracticePractitioner - General Practice 8123080496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lewis Gale Physicians LLCGroup PAC ID 6507886231, 191 clinicians

Practice addresses (Care Compare)

10 Hickok St
Christiansburg, VA 24073-3546
Phone (540) 381-1882

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.25 of 100Reported as individual
Quality
82.76
Promoting interoperability
100
Improvement activities
40
Cost
64.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101235860VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly Medical Services Corporation LLC Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: carl.hannah@hca6.eclinicaldirectplus.com

Organizations & group practices 2

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 4

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1700848363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HICKOK ST",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240733524",
            "telephone_number": "540-383-6148",
            "fax_number": "540-382-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 HICKOK ST",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240733524",
            "telephone_number": "540-383-6148",
            "fax_number": "540-382-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAH",
        "first_name": "CARL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101235860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER",
            "identifier": "010098891",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI PROVIDER NUMBER",
            "identifier": "3131709",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH PROVIDER",
            "identifier": "245710",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "144661",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2065534",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "5389156",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00240702",
            "state": "VI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010098891",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700848363",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "7161454",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CARL.HANNAH@hca6.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "6 Hickok St",
            "city": "Christiansburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240733524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Christiansburg, VA

Sources for this page

Verify at the official NPI Registry.