Active NPI
Charles H. Parker Jr., M. D.
- Gastroenterology Physician
- South Boston, VA
National Provider Identifier
1912963091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 0101041330
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005840970 | Medicaid | VA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101041330 | VA | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Halifaxmed, PLC | Current | Accepting new patients | |
| Digestive Care PC | Gastroenterology | Current | Accepting new patients |
| Patrick Henry Boys and Girls Plantation, Inc | Past | 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.
-
- Gastroenterology Physician
- Danville, VA
- NPI 1871319392
-
- Family Medicine Physician
- South Boston, VA
- NPI 1174551725
-
- Professional Counselor
- Lynchburg, VA
- NPI 1710185897
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.