Jack Wayne Higginbotham Jr. (NPI# 1700859253, PAC ID# 0749271088) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1700859253 |
| PAC ID by PECOS | 0749271088 |
| Professional Enrollment ID | I20040524001048 |
| Full Name | Jack Wayne Higginbotham Jr. |
| Organization Legal Name | CHARLOTTESVILLE RADIOLOGY LTD |
| Address |
435 Merchant Walk Sq Suite 400 Charlottesville VA 22902-6516 |
| Phone Number | 4346541800 |
| Gender | M |
| Credential | MD |
| Medical School | MEDICAL COLLEGE OF VIRGINIA COMMONWEALTH UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 1557259959 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490077 | SENTARA MARTHA JEFFERSON HOSPITAL |
| 490009 | UNIVERSITY OF VIRGINIA MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3263 Proffit Rd, Charlottesville, VA 22911-5639 | 4346547106 | CHARLOTTESVILLE RADIOLOGY LTD |
| 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 | 4346541800 | CHARLOTTESVILLE RADIOLOGY LTD |
| 500 Martha Jefferson Dr, Charlottesville, VA 22911-4668 | 4346547106 | CHARLOTTESVILLE RADIOLOGY LTD |
| 595 Martha Jefferson Dr, Charlottesville, VA 22911-4669 | 4346547106 | CHARLOTTESVILLE RADIOLOGY LTD |
| 29 Jefferson Ct, Zion Crossroads, VA 22942-9602 | 4346547106 | CHARLOTTESVILLE RADIOLOGY LTD |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 100% | |
| MIPS_EC_147_overall | Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy | 100% | |
| MIPS_EC_225_overall | Radiology: Reminder System for Screening Mammograms | 100% | |
| MIPS_EC_436_overall | Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques | 100% |
| Organization Legal Name | CHARLOTTESVILLE RADIOLOGY LTD |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jay C Fertile | Diagnostic Radiology | Charlottesville Radiology Ltd | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Christopher D Cook | Diagnostic Radiology | Charlottesville Radiology Ltd | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Jonathan M Ciambotti | Diagnostic Radiology | Charlottesville Radiology Ltd | 500 Martha Jefferson Dr, Charlottesville, VA 22911-4668 |
| Victor C Peyton | Diagnostic Radiology | Charlottesville Radiology Ltd | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Sean James Lyman | Diagnostic Radiology | Charlottesville Radiology Ltd | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Pradeep Rajagopalan | Diagnostic Radiology | Charlottesville Radiology Ltd | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Anthony W Spinelli | Diagnostic Radiology | Charlottesville Radiology Ltd | 500 Martha Jefferson Dr, Charlottesville, VA 22911-4668 |
| Clinton S Pease | Diagnostic Radiology | Charlottesville Radiology Ltd | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Street Address |
435 MERCHANT WALK SQ SUITE 400 |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip | 22902-6516 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Blake R Garmon | Internal Medicine | Martha Jefferson Medical Group LLC | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Jay C Fertile | Diagnostic Radiology | Charlottesville Radiology Ltd | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Gregory G Degnan | Orthopedic Surgery | Martha Jefferson Medical Group LLC | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Christopher D Cook | Diagnostic Radiology | Charlottesville Radiology Ltd | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Melissa Leigh Morgan | Nurse Practitioner | Martha Jefferson Medical Group LLC | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Victor C Peyton | Diagnostic Radiology | Charlottesville Radiology Ltd | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Joseph B Evans | Internal Medicine | Martha Jefferson Medical Group LLC | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Sean James Lyman | Diagnostic Radiology | Charlottesville Radiology Ltd | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Pradeep Rajagopalan | Diagnostic Radiology | Charlottesville Radiology Ltd | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Clinton S Pease | Diagnostic Radiology | Charlottesville Radiology Ltd | 435 Merchant Walk Sq, Suite 400, Charlottesville, VA 22902-6516 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Hope B Bagley | Clinical Psychologist | 922 9, Charlottesville, VA 22902 | |
| Peter Sheras | Psychologist, Clinical | 100 E S St, Suite 5, Charlottesville, VA 22902 | |
| Rebecca L Ginsberg | Psychologist, Clinical | 100 E S St, Suite 5, Charlottesville, VA 22902 | |
| Claudia Cnm Sencer | Certified Nurse Midwife (cnm) | 730 Lyons Ave, Charlottesville, VA 22902-4310 | |
| Robin Churchill Bernhard | Clinical Social Worker | 420 3rd St Ne, Charlottesville, VA 22902-4620 | |
| James William Tickel | Chiropractic | 409 8th St Ne, Charlottesville, VA 22902-4727 | |
| Michael A Goldman | Podiatry | 417 8th St Ne, Charlottesville, VA 22902-4727 | |
| Thomas Schildwachter | Orthopedic Surgery | 914 E Jefferson St, Suite 102, Charlottesville, VA 22902-4745 | |
| Anne-lise Smith | Psychologist, Clinical | 421 Park St, Suite B, Charlottesville, VA 22902-4749 | |
| James D Aller | Internal Medicine | 908 E Jefferson St, Suite G1, Charlottesville, VA 22902-4800 | |
| Find all physicians in zip 22902 | |||
| City | CHARLOTTESVILLE |
| Zip Code | 22902 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | CHARLOTTESVILLE + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Jack Wayne Higginbotham Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.