CLIFFORD P. CULPEPPER M.D.
NPI 1225036502
Internal Medicine - Nephrology in Roanoke, VA
NPI Status: Active since July 12, 2005
Contact Information
2602 FRANKLIN RD SW
ROANOKE, VA
ZIP 24014
Phone: (540) 344-1400
Fax: (540) 344-7133
- Individual
- Male
- Internal Medicine
- Nephrology
- PECOS Enrolled
- Medicare Quality Reporting
About CLIFFORD CULPEPPER
This page provides the complete NPI Profile along with additional information for Clifford Culpepper, an internist established in Roanoke, Virginia with a medical specialization in Internal Medicine, focusing in nephrology . The healthcare provider is registered in the NPI registry with number 1225036502 assigned on July 2005. The practitioner's primary taxonomy code is 207RN0300X with license number 0101031211 (VA). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1225036502
- Provider Name
- CLIFFORD P. CULPEPPER M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2602 FRANKLIN RD SW ROANOKE, VA 24014
- Location Phone
- (540) 344-1400
- Location Fax
- (540) 344-7133
- Mailing Address
- 2602 FRANKLIN RD SW ROANOKE, VA 24014
- Mailing Phone
- (540) 344-1400
- Mailing Fax
- (540) 344-7133
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-12-2005
- Last Update Date
- 04-12-2016
- Code Navigator
An internist like Clifford Culpepper is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Nephrology
- Taxonomy Code
- 207RN0300X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 0101031211
- License State
- VA
- Taxonomy Description
- An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| CG1162 | OTHER (01) | VA | RR MEDICARE GROUP |
| CU0651712 | OTHER (01) | WV | WEST VA MEDICARE LEGACY |
| 6036651 | MEDICAID (05) | VA | |
| B61450 | MEDICARE UPIN (02) | VA |
Medicare Participation & PECOS Enrollment Status
Clifford Culpepper is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 24014 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $129.04
- Minimum New Patient Price $56.19
- Maximum New Patient Price $170.3
- Average New Patient Copayment $32.26
- Minimum New Patient Copayment $14.04
- Maximum New Patient Copayment $42.57
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $99.13
- Minimum Established Patient Price $18.07
- Maximum Established Patient Price $138.91
- Average Established Patient Copayment $24.78
- Minimum Established Patient Copayment $4.51
- Maximum Established Patient Copayment $34.72
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Diabetes: Medical Attention for Nephropathy | 97% | 104 |
| The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period | ||
| e-Prescribing | 83% | 724 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Medication Reconciliation | 99% | 72 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 10% | 148 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Pneumococcal Vaccination Status for Older Adults | 22% | 202 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Population empanelment | Yes | N/A |
| Empanel (assign responsibility for) the total population, linking each patient to a MIPS eligible clinician or group or care team. Empanelment is a series of processes that assign each active patient to a MIPS eligible clinician or group and/or care team, confirm assignment with patients and clinicians, and use the resultant patient panels as a foundation for individual patient and population health management. Empanelment identifies the patients and population for whom the MIPS eligible clinician or group and/or care team is responsible and is the foundation for the relationship continuity between patient and MIPS eligible clinician or group /care team that is at the heart of comprehensive primary care. Effective empanelment requires identification of the “active population” of the practice: those patients who identify and use your practice as a source for primary care. There are many ways to define “active patients” operationally, but generally, the definition of “active patients” includes patients who have sought care within the last 24 to 36 months, allowing inclusion of younger patients who have minimal acute or preventive health care. | ||
| Provide Patient Access | 14% | 148 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Regular Review Practices in Place on Targeted Patient Population Needs | Yes | N/A |
| Implementation of regular reviews of targeted patient population needs, such as structured clinical case reviews, which includes access to reports that show unique characteristics of eligible clinician's patient population, identification of vulnerable patients, and how clinical treatment needs are being tailored, if necessary, to address unique needs and what resources in the community have been identified as additional resources. | ||
| Secure Messaging | 5% | 148 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Syndromic Surveillance Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit syndromic surveillance data. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_2_MULTI. | ||
| Use of High-Risk Medications in the Elderly | 1% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 202 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 2 | 5 | 0 | 3 | 6 | 5 | 0 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 4 | 5 | 0 | 3 | 12 | 5 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 4 + 5 + 0 + 3 + 1 + 2 + 5 + 0 + 24 = 48 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 48 = 2 | 2 | ||||||||
The NPI number 1225036502 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1568447704 | VICKY KELLEY N.P. Individual | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1770688145 | PHYSICIANS CARE OF VIRGINIA PC Organization | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 343-2268 |
| 1902804180 | MATT MATHEW M.D. Individual | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1962486563 | RESSIE LOUISE SHUPE A.C.N.P. Individual | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1821072422 | REBECCA S GOBLE N.P. Individual | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1114983681 | DEBRA C. DOOLEY N.P. Individual | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1750526075 | REBECCA D HUGHES F.N.P. Individual | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1881148732 | JESSICA M SAUNDERS Individual | Nurse Practitioner (Family) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1518151620 | DR. ABDELAZIZ ALI ELSANJAK M.D. Individual | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1760485635 | DR. STEPHEN LAURENCE HILL M.D. Individual | Surgery (Vascular Surgery) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1053436923 | REBIN THOMAS TITUS M.D. Individual | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1033779814 | KRISTIE JEARLS RD Individual | Dietitian, Registered | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 798-3108 |
| 1821647330 | JEARLS NUTRITION, LLC Organization | Dietitian, Registered | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 798-3108 |
| 1871988386 | DENNIS HU MD Individual | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1770581761 | JAMES S. CAIN M.D. Individual | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1104824390 | EDGAR R ESCASINAS M.D. Individual | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1447258728 | FRED JACKSON BALLENGER M.D. Individual | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1073762829 | MRS. ROBIN HURT WRIGHT FNP-BC Individual | Family Medicine | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1982368742 | CHRISTINE LAWSON NP Individual | Nurse Practitioner | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
| 1265489504 | DR. SHAHRAM AHMADZADEH M.D. Individual | Internal Medicine (Nephrology) | 2602 FRANKLIN RD SW ROANOKE, VA 24014 (540) 344-1400 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1225036502, enumerated in the NPI registry as an "individual" on July 12, 2005
The provider is located at 2602 Franklin Rd Sw Roanoke, Va 24014 and the phone number is (540) 344-1400
The provider's speciality is Internal Medicine with taxonomy code 207RN0300X with a focus in Nephrology
The provider might be accepting Accepts: Railroad Medicare, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $129.04 with an average copayment of $32.26 for new patient appointments. Established patients should expect a typical charge of $99.13 and an average copayment of 24.78. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on July 12, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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