Jack W. Higginbotham, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

0101232780 Issued in VA

Practice address

500 Martha Jefferson Dr
Charlottesville Radiology
Charlottesville, VA 22911-4668

Phone

(434) 244-4580

Fax

(434) 244-4579

NPI assigned

Feb 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 2

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

Specialty

Diagnostic Radiology

Education

Virginia Commonwealth University, School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charlottesville Radiology LTDGroup PAC ID 1557259959, 10 clinicians

Augusta Medical GroupGroup PAC ID 3678632544, 409 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Martha Jefferson Hospital Hospital, Charlottesville, VA, CCN 490077
• Sentara RMH Medical Center Hospital, Harrisonburg, VA, CCN 490004
• University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009
• Augusta Health Hospital, Fishersville, VA, CCN 490018

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jhigginbotham246099@direct.sentara.net
• FHIR API: https://api.platform.athenahealth.com/14718/brand/4/csg/1/fhir/r4

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.

• Augusta Medical Group

  • General Practice Physician
  • Fishersville, VA
  • NPI 1245489590
  Medicare reassignment Care Compare group NPD
• Charlottesville Radiology LTD

  • Diagnostic Radiology Physician
  • Charlottesville, VA
  • NPI 1205884962
  Medicare reassignment Care Compare group NPD
• Augusta Health Care, Inc.

  • Diagnostic Radiology Physician
  • Fishersville, VA
  • NPI 1720717044
  Medicare reassignment NPD
• Augusta Health Care, Inc

  • General Acute Care Hospital
  • Fishersville, VA
  • NPI 1053301127
  NPD
• Augusta Medical Group

  • Rural Health Clinic/Center
  • Lexington, VA
  • NPI 1265015580
  NPD
• Sentara Advanced Imaging Solutions, LLC

  • Diagnostic Radiology Physician
  • Charlottesville, VA
  • NPI 1144941808
  NPD
• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  NPD (past)
• Allegheny Clinic Radiology

  • Diagnostic Radiology Physician
  • Pittsburgh, PA
  • NPI 1992183164
  NPD (past)
• Radiology Physicians Inc

  • Diagnostic Radiology Physician
  • Dayton, OH
  • NPI 1851390850
  NPD (past)

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

• Augusta Health Care, Inc

  • General Acute Care Hospital
  • Fishersville, VA
  • NPI 1053301127
  Care Compare affiliation
• Martha Jefferson Hospital

  • General Acute Care Hospital
  • Charlottesville, VA
  • NPI 1346248663
  Care Compare affiliation
• Rector & Visitors of the University of Virginia

  • General Acute Care Hospital
  • Charlottesville, VA
  • NPI 1780630608
  Care Compare affiliation
• Sentara RMH Medical Center

  • General Acute Care Hospital
  • Harrisonburg, VA
  • NPI 1780694372
  Care Compare affiliation

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1700859253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 197",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168040197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR",
            "address_2": "CHARLOTTESVILLE RADIOLOGY",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114668",
            "telephone_number": "434-244-4580",
            "fax_number": "434-244-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINBOTHAM",
        "first_name": "JACK",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101232780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010140242",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMED",
            "identifier": "P00224457",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhigginbotham246099@direct.sentara.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 Martha Jefferson Dr",
            "address_2": "Charlottesville Radiology",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229114668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhigginbotham246099@direct.sentara.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 Martha Jefferson Dr",
            "address_2": "Charlottesville Radiology",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229114668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jamie H Hicks, NNP
• Joshua Hicks
• Tiana Nicole Hickson, MSW
• Yolanda Hidalgo
• Douglas Hidlay, M.D.
• Kimberly Joy Higginbotham, PA
• Darcy J. Higgins, MS, PT
• Michael Higgins, ATC, PT, CSCS
• Terri Higgins, L.P.C.
• Kate A Higginson, PA

• Diagnostic Radiology Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Diagnostic Radiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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.