Individual provider Active NPI

Charles H. Parker Jr., M. D.

  • Gastroenterology Physician
  • South Boston, VA
National Provider Identifier
1912963091
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101041330 Issued in VA
Practice address
1627 Seymour Dr
South Boston, VA 24592-3428
Phone
(434) 572-1171
Fax
(434) 572-1776
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0101041330 VA Primary

Addresses

Primary practice location

1627 Seymour Dr
South Boston, VA 24592-3428

Mailing address

1627 Seymour Dr
PO Box 397
South Boston, VA 24592-3428
Phone (434) 572-1171

Other identifiers 1

IdentifierTypeStateIssuer
005840970MedicaidVA

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
I20061127000187 VA Practitioner - GastroenterologyPractitioner - Internal Medicine 4082643762 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101041330VAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Halifaxmed, PLC CurrentSince May 20, 2006 Accepting new patients
Digestive Care PC Gastroenterology CurrentSince Sep 1, 2025 Accepting new patients
Patrick Henry Boys and Girls Plantation, Inc PastSince Sep 24, 2016 Accepting new patients

Locations

501 Rison St
Ste 130
Danville, VA 24541
Phone (434) 429-4290

1627 Seymour Dr
South Boston, VA 24592
Phone (434) 517-0611

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1912963091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 SEYMOUR DR",
            "address_2": "PO BOX 397",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245923428",
            "telephone_number": "434-572-1171",
            "fax_number": "434-572-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 SEYMOUR DR",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245923428",
            "telephone_number": "434-572-1171",
            "fax_number": "434-572-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "CHARLES",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101041330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005840970",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, VA

Sources for this page

Verify at the official NPI Registry.