CLARENCE E PEARSON (MD) – Cardiovascular Disease Physician, NPI 1083618987
Cardiovascular Disease Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,521 CARDIOVASCULAR DISEASE (CARDIOLOGY) in FL
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Provider Addresses for CLARENCE E PEARSON (MD)
307 BOATNER RD STE 114
EGLIN AFB, FL 325421302
Phone: (850) 883-8600
Fax: (575) 625-8452
Type: Mailing
96th Medical Group, 307, Boatner Road, Okaloosa County, Florida, 32542, United States
SUITE 114
EGLIN AFB, FL 325421302
Phone: (850) 883-8600
Type: Location
213 S JEFFERSON ST STE 1006
ROANOKE, VA 240111713
Phone: (540) 224-5372
Type: Mailing
1107B BROOKDALE ST
MARTINSVILLE, VA 241124501
Phone: (276) 634-4400
Fax: (276) 638-2900
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-06-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210609002088 | I | Cardiovascular Disease (Cardiology) | VA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32542)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | VA | |
| Physician Assistant | VA | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | VA | |
| Nurse Practitioner | VA | |
| Nurse Practitioner | VA | |
| - | VA | |
| Family Practice | MI | |
| Nurse Practitioner | VA | |
| - | VA |
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