DR. CANDACE RENEE CLOCKER (NPI# 1841488905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841488905 |
| Entity Type | Individual |
| Full Name | DR. CANDACE RENEE CLOCKER |
| Credential | M.D. |
| Practice Address |
2100 Wilborn Ave South Boston VA 24592-1628 |
| Practice Telephone | 4345178022 |
| Practice Fax Number | 4345178370 |
| Mailing Telephone | 4345178022 |
| Mailing Fax Number | 4345178370 |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2017-02-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
33110 | SC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | LICENSE NUMBER | 33110 | 01 |
| Street Address |
2100 WILBORN AVE |
| City | SOUTH BOSTON |
| State | VA |
| Zip Code | 24592-1628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063412179 | Roger W Browne | Internal Medicine | 2100 Wilborn Ave, South Boston, VA 24592-1628 | 2005-07-29 |
| 1841809241 | Halifax Regional Hospital, Inc | Clinic/Center | 2100 Wilborn Ave, South Boston, VA 24592-1628 | 2020-07-31 |
| 1164721668 | Anne Jennifer Lombardi | Pediatrics | 2100 Wilborn Ave, South Boston, VA 24592-1628 | 2011-03-23 |
| 1659444586 | Halifax Ear Nose and Throat Center PC | Specialist | 2100 Wilborn Ave, South Boston, VA 24592-1628 | 2006-11-16 |
| 1578633301 | Jason Channing Coleman | Pediatrics | 2100 Wilborn Ave, South Boston, VA 24592-1628 | 2006-11-09 |
| 1386612877 | Maria Precious Tangan Torres | Pediatrics | 2100 Wilborn Ave, South Boston, VA 24592-1628 | 2006-03-09 |
| 1568447688 | Charles Spencer Bibbs | Emergency Medicine | 2100 Wilborn Ave, South Boston, VA 24592-1628 | 2005-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966398 | Transformations Center for Health Wellness LLC | Counselor | 2170 Sandy Beach Road, South Boston, VA 24592 | 2019-11-12 |
| 1740830215 | Kirstyn Lokker | Occupational Therapist | 1 High School Circle, South Boston, South Boston, VA 24592 | 2019-09-17 |
| 1841764248 | Nicole Ivey | Occupational Therapy Assistant | 103 Rosehil Rd, South Boston, VA 24592 | 2019-01-18 |
| 1841700960 | Bio-medical Applications of Virginia, Inc. | Clinic/Center | 130 Aubreys Loop, South Boston, VA 24592 | 2017-10-03 |
| 1659828820 | Family Preservation Services, Inc | Community/Behavioral Health | 1 High School Circle, South Boston, VA 24592 | 2016-09-06 |
| 1316222821 | Family and Children Enrichment Services Inc. | Health Maintenance Organization | 220 Paradise Lane, South Boston, VA 24592 | 2011-10-15 |
| 1326365578 | Brinda Howard | Nurse's Aide | 104 Love Shop Park Rd Lot #25, South Boston, VA 24592 | 2010-04-28 |
| 1356513543 | Betts Medical Supplies, LLC. | Durable Medical Equipment & Medical Supplies | 403 Factory Street, Suite B, South Boston, VA 24592 | 2008-03-27 |
| 1407051873 | Dominion Health Medical Assoc | Legal Medicine | 101 Aubrey's Loop Rd, South Boston, VA 24592 | 2007-06-18 |
| 1437352945 | Behavioral Health Associates, Inc. | Non-emergency Medical Transport (VAN) | 515 Yancey Ave, South Boston, VA 24592 | 2007-06-11 |
| Find all providers in zip 24592 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124626478 | Partners In Family Practice LLC | Clinic/Center | 430 Clairmont Ct Ste 123, Colonial Heights, VA 23834-1770 | 2020-10-09 |
| 1730790874 | Janice G. Sadaya-conda M.d., Pllc | Clinic/Center | 6128 Brandon Ave Ste 225, Springfield, VA 22150-2640 | 2020-08-12 |
| 1598375610 | Johnson Venture Management Solutions, Inc. | Clinic/Center | 17 Langley Blvd Bldg 1216, Hampton, VA 23681-2143 | 2020-08-04 |
| 1376161745 | Susan Minter Dnp Aprn LLC | Clinic/Center | 1234 Ridout Rd, La Crosse, VA 23950-2808 | 2020-07-11 |
| 1295359883 | Advanced Onsite Care LLC | Clinic/Center | 1045 Robert Welch Ln, Chesapeake, VA 23320-6770 | 2020-05-30 |
| 1962022392 | Gladeview Medical LLC | Clinic/Center | 279 Gladeview Dr, Fries, VA 24330-3936 | 2020-04-27 |
| 1578182986 | Libertas Leadership | Clinic/Center | 405 Sperryville Pike, Culpeper, VA 22701-2151 | 2020-04-15 |
| 1497395768 | Holistic Health and Healing Inc | Clinic/Center | 3690 Greensboro Road, Ridgeway, VA 24148 | 2020-01-14 |
| 1700426244 | Quad/med, LLC | Clinic/Center | 366 Draft Avenue, Stuarts Draft, VA 24477-2941 | 2020-01-13 |
| 1114560653 | Amy Beyer LLC | Clinic/Center | 2611 Thomas Jefferson Pkwy, Palmyra, VA 22963-5000 | 2019-10-28 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BOSTON |
| Zip Code | 24592 |
Please comment or provide details below to improve the information on DR. CANDACE RENEE CLOCKER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.