Carolyn Lynn St Clair, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110001841 Issued in VA

Practice address

4550 Lee Hwy Ste a
Dublin, VA 24084-3802

Phone

(540) 440-3170

Fax

(540) 674-5544

NPI assigned

Jul 31, 2006

Sex

Female

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: carolyn.stclair@hca6.eclinicaldirectplus.com

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1700892775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WALNUT AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164719",
            "telephone_number": "540-345-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 LEE HWY STE A",
            "city": "DUBLIN",
            "state": "VA",
            "postal_code": "240843802",
            "telephone_number": "540-440-3170",
            "fax_number": "540-674-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST CLAIR",
        "first_name": "CAROLYN",
        "middle_name": "LYNN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700892775",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carolyn.stclair@hca6.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4550 Lee Hwy Ste A",
            "city": "Dublin",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240843802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Matthew Skewes, MD
• Jacqueline Clouse Snell, ATC
• Autumn D. Snider
• Southwest Podiatry, P.C.
• Daniel Keith Spencer, AGPCNP-BC
• Stable Haven Counseling PLLC
• Knotresha Floreth Stewart, M.D.
• Gregory L. Still, MD
• William Thompson
• Christine Marie Ullman, D.O.

• Physician Assistant in Dublin, VA
• Providers in Dublin, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.