DR. CANDACE RENEE CLOCKER M.D.
NPI 1841488905
Pediatrics in South Boston, VA

Q: What is Candace Clocker's NPI number?

The NPI number for Candace Clocker is 1841488905. It was assigned to this individual provider in the NPPES registry on October 12, 2007.

Q: What is Candace Clocker's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Candace Clocker was last updated on March 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 12, 2007PECOS Enrolled

2100 WILBORN AVE, SOUTH BOSTON, VA 24592(434) 517-8022(434) 517-8370 Get Directions Write a Review

NPPES record last updated: March 7, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 7, 2024, Nov 23, 2020, Feb 2, 2017 (3 updates tracked since 2017).

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About Dr. Candace Renee Clocker M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CANDACE RENEE CLOCKER M.D. (NPI 1841488905) is an individual pediatrics provider in South Boston, Virginia, licensed in Virginia (0101261852) and active in the NPI registry since October 2007. She is enrolled in Medicare PECOS and maintains a secondary practice location in Elizabeth City.

NPPES Registry Identity

NPI1841488905

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. CANDACE RENEE CLOCKERCredential: M.D.

Location Address2100 WILBORN AVESouth Boston, VA 24592-1628

Mailing Address2100 Wilborn AveSouth Boston, VA 24592-1628 · (434) 517-8022 · Fax (434) 517-8370

Phone(434) 517-8022

Fax(434) 517-8370

Sole ProprietorYes

Enumeration DateOctober 12, 2007

Last NPPES UpdateMarch 7, 20243 updates tracked since enumeration

NPPES CertifiedMarch 7, 2024

✔ NPI 1841488905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in VA · 0101261852✔ Licensed in NC · 2013-01833

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X · License 33110 (SC)

2100 WILBORN AVE, South Boston, VA 24592

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Secondary Practice Location 1

Location 11141 N Road St Ste MElizabeth City, NC 27909-3354 · Phone (252) 384-2590

Other Identifiers 1

Other33110SC · License Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Candace Renee Clocker M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Candace Clocker reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Halifax Regional Hospital, Inc.

0.1 mi

General Acute Care Hospital

2204 WILBORN AVE
South Boston, VA 24592

Reassigned Medicare billing, Virginia enrollment
44 clinicians in this Medicare group

NPI 1588668842 (434) 517-3100

Albemarle Physician Services - Sentara, Inc

150 mi

Neurology

1144 N ROAD ST
Elizabeth City, NC 27909

Reassigned Medicare billing, North Carolina enrollment
176 clinicians in this Medicare group

NPI 1407124654 (252) 384-4804

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24592 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROGER W BROWNE MD

Internal Medicine