Active NPI 1083702385 Individual Practitioner Male Practitioner

Dr. Ronald D Haggerty , MD

Internal Medicine • Gloucester, VA

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Ronald Haggerty, MD is a certified Internal Medicine practicing in Gloucester, VA. With approximately 31 years of clinical experience since graduating from Wayne State University School Of Medicine in 1995, Dr. Haggerty delivers high-quality medical care to the local community at 6609 MAIN ST.

Dr. Haggerty maintains professional affiliations with Rappahannock Westminster-Canterbury, Inc., Direct Access Internal Medicine Ltd and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, administration of influenza virus vaccine, injection, triamcinolone acetonide, not otherwise specified, 10 mg. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

6609 Main St

Gloucester, VA 230615194

Telephone 8048249153

Fax 8046943174

Associated Practice Facility / Clinic

🏢 Direct Access Internal Medicine Ltd Facility NPI 1639476831

Medicare Profile & Education

Medical School

Wayne State University School Of Medicine

Graduation Year

1995

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Gloucester, VA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

31 Yrs +2.7 yrs vs City Avg

City Avg: 28.3 Yrs

State Avg: 26.1 Yrs

Regional Practice Density

12 Specialists

Practicing in Gloucester, VA (3758 Statewide)

Telehealth Adoption Rate

33.3% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

43.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Haggerty (31 Years) 31 Yrs

Gloucester Specialty Average (28.3 Years) 28.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	877	424	$191.00	$115.96
99213 Established patient office or other outpatient visit, typically 15 minutes	289	187	$135.00	$82.14
G0008 Administration of influenza virus vaccine	235	233	$48.00	$31.41
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	232	43	$16.00	$0.96
90656 Vaccine for influenza for administration into muscle, 0.5 ml dosage	225	225	$47.00	$21.90
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	92	72	$267.00	$163.10
36415 Insertion of needle into vein for collection of blood sample	79	50	$25.00	$8.65
93000 Routine ekg using at least 12 leads including interpretation and report	69	56	$45.00	$12.90
81003 Automated urinalysis test	68	52	$25.00	$2.20
80047 Blood test, basic group of blood chemicals (calcium, ionized)	66	42	$28.00	$13.46
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	52	50	$85.00	$51.44
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	51	39	$29.00	$21.03
20610 Aspiration and/or injection of fluid from large joint	48	40	$122.00	$59.62
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	47	23	$102.00	$69.89
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	43	39	$129.00	$68.13
93244 Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days	42	37	$59.00	$20.44
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	36	19	$147.00	$105.11
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	29	26	$285.00	$154.19
99238 Hospital discharge day management, 30 minutes or less	17	17	$102.00	$71.95
G0009 Administration of pneumococcal vaccine	14	13	$48.00	$31.41
85014 Red blood cell concentration measurement	13	11	$10.00	$2.32

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	878	404	$167.84	$124.76
99213 Established patient office or other outpatient visit, typically 15 minutes	268	177	$119.26	$88.01
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	265	264	$47.00	$21.89
G0008 Administration of influenza virus vaccine	265	264	$48.00	$30.15
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	209	152	$129.00	$49.09
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	153	121	$233.01	$172.23
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	99	25	$16.00	$1.06
93000 Routine ekg using at least 12 leads including interpretation and report	69	57	$45.00	$14.16
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	57	23	$102.00	$77.12
93244 Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days	56	48	$59.00	$22.86
81003 Automated urinalysis test	54	43	$25.00	$2.20
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	48	40	$285.00	$166.49
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	46	21	$147.00	$116.01
99238 Hospital discharge day management, 30 minutes or less	41	32	$102.00	$78.80
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	37	36	$73.97	$55.41
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	33	28	$99.00	$34.62
87804 Detection test by immunoassay with direct visual observation for influenza virus	26	13	$55.00	$16.22
20610 Aspiration and/or injection of fluid from large joint	24	23	$122.00	$63.32
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	21	17	$29.00	$22.80
90471 Administration of 1 vaccine	11	11	$53.00	$19.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	976	400	$150.00	$126.75
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	305	195	$99.00	$34.96
99213 Established patient office or other outpatient visit, typically 15 minutes	269	188	$98.00	$90.02
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	265	265	$47.00	$21.09
G0008 Administration of influenza virus vaccine	265	265	$47.85	$29.33
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	118	86	$202.00	$180.12
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	96	21	$16.00	$1.14
93000 Routine ekg using at least 12 leads including interpretation and report	87	72	$45.00	$14.27
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	87	75	$129.00	$30.32
81003 Automated urinalysis test	60	45	$25.00	$2.22
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	56	20	$102.00	$70.07
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	55	23	$147.00	$100.66
M0222 Intravenous injection, bebtelovimab, includes injection and post administration monitoring	47	47	$420.00	$342.23
Q0222 Injection, bebtelovimab, 175 mg	45	45	$2.89	$0.01
87804 Detection test by immunoassay with direct visual observation for influenza virus	40	21	$55.00	$16.41
93244 Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days	36	34	$59.00	$24.21
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	34	28	$29.00	$23.15
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	31	26	$61.00	$53.75
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	28	24	$285.00	$188.18
0124A Fee covid-19 vac 13 res	26	26	$88.00	$38.81
91312 Coronavirus vaccine 13	26	26	$0.01	$0.01
99238 Hospital discharge day management, 30 minutes or less	25	20	$102.00	$70.79
M0247 Intravenous infusion, sotrovimab, includes infusion and post administration monitoring	18	18	$679.00	$429.06
Q0247 Injection, sotrovimab, 500 mg	17	17	$0.01	$0.01
20610 Aspiration and/or injection of fluid from large joint	17	16	$122.00	$60.12
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	15	11	$137.00	$88.94
99239 Hospital discharge day management, more than 30 minutes	12	12	$149.00	$103.21
0003A Adm sarscov2 30mcg/0.3ml 3rd	11	11	$68.00	$39.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,003	404	$150.00	$129.74
G0008 Administration of influenza virus vaccine	278	277	$28.00	$17.01
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	278	278	$47.00	$20.53
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	277	179	$99.00	$35.33
85610 Blood test, clotting time	251	19	$20.00	$4.29
99213 Established patient office or other outpatient visit, typically 15 minutes	187	146	$98.00	$91.53
0012A Adm sarscov2 100mcg/0.5ml2nd	172	170	$60.00	$32.16
0011A Adm sarscov2 100mcg/0.5ml1st	166	166	$42.17	$18.25
0003A Adm sarscov2 30mcg/0.3ml 3rd	164	165	$68.37	$39.93
0013A Adm sarscov2 100mcg/0.5ml3rd	161	161	$68.00	$39.93
0001A Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 30 mcg/0.3ml dosage, diluent reconstituted; first dose	151	148	$54.17	$33.10
0002A Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 30 mcg/0.3ml dosage, diluent reconstituted; second dose	148	147	$60.00	$39.93
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	145	99	$202.00	$178.79
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	96	32	$102.00	$71.42
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	92	20	$147.00	$102.64
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	76	12	$16.00	$1.26
93000 Routine ekg using at least 12 leads including interpretation and report	61	52	$45.00	$14.89
81003 Automated urinalysis test	54	43	$25.00	$2.25
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	44	32	$285.00	$199.00
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	42	38	$129.00	$63.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	39	37	$61.00	$55.73
99238 Hospital discharge day management, 30 minutes or less	36	28	$102.00	$71.78
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	31	26	$29.00	$22.91
93241 Heart rhythm recording, analysis, report, review, and interpretation of continous external ekg over more than 48 hours up to 7 days	24	24	$175.00	$160.00
20610 Aspiration and/or injection of fluid from large joint	18	12	$122.00	$64.96
93244 Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days	13	12	$59.00	$24.67
G0009 Administration of pneumococcal vaccine	13	12	$48.00	$17.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	886	364	$150.00	$108.08
99213 Established patient office or other outpatient visit, typically 15 minutes	340	203	$98.00	$73.43
85610 Blood test, clotting time	298	17	$20.00	$4.26
G0008 Administration of influenza virus vaccine	230	228	$28.00	$16.76
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	230	228	$47.00	$19.57
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	152	110	$99.00	$35.33
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	102	84	$202.00	$146.78
93000 Routine ekg using at least 12 leads including interpretation and report	95	73	$45.00	$17.09
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	71	17	$16.00	$1.43
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	64	58	$61.00	$43.17
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	54	21	$102.00	$70.52
81003 Automated urinalysis test	51	40	$25.00	$2.24
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	44	16	$147.00	$102.99
99238 Hospital discharge day management, 30 minutes or less	31	28	$102.00	$71.46
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	31	27	$285.00	$198.17
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	28	22	$29.00	$22.65
20610 Aspiration and/or injection of fluid from large joint	22	17	$122.00	$61.55
G0009 Administration of pneumococcal vaccine	22	22	$48.00	$16.67
0296T External EKG recording for more than 48 hours up to 21 days	20	19	$60.00	$12.18
0298T Review and interpretation of external EKG recording for more than 48 hours up to 21 days	20	19	$61.00	$25.19
90670 Pneumococcal vaccine for injection into muscle	15	15	$292.33	$222.15
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic	14	14	$35.00	$14.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	871	349	$150.00	$104.50
85610 Blood test, clotting time	319	19	$20.00	$4.28
99213 Established patient office or other outpatient visit, typically 15 minutes	265	174	$98.00	$71.38
G0008 Administration of influenza virus vaccine	262	260	$28.00	$16.42
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	259	259	$47.00	$18.65
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	151	111	$202.00	$140.45
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	85	30	$102.00	$64.56
93000 Routine ekg using at least 12 leads including interpretation and report	82	57	$45.00	$16.34
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	73	28	$147.00	$99.77
81003 Automated urinalysis test	63	53	$25.00	$2.44
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	54	49	$61.00	$43.27
G0009 Administration of pneumococcal vaccine	44	42	$48.00	$16.42
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	35	32	$285.00	$191.16
99238 Hospital discharge day management, 30 minutes or less	35	27	$102.00	$68.69
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	34	30	$29.00	$21.72
90670 Pneumococcal vaccine for injection into muscle	29	29	$220.00	$207.57
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	15	15	$132.00	$110.24
J1030 Injection, methylprednisolone acetate, 40 mg	15	12	$26.00	$6.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	742	304	$150.00	$100.75
85610 Blood test, clotting time	418	24	$20.00	$4.75
99213 Established patient office or other outpatient visit, typically 15 minutes	374	205	$98.00	$68.18
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	192	187	$54.00	$23.57
G0008 Administration of influenza virus vaccine	192	187	$28.00	$20.24
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	104	84	$61.00	$41.11
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	101	44	$29.00	$20.31
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	87	71	$202.00	$135.80
93000 Routine ekg using at least 12 leads including interpretation and report	77	63	$45.00	$15.88
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	74	21	$102.00	$68.23
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	59	15	$147.00	$97.74
81003 Automated urinalysis test	56	41	$25.00	$2.71
G0009 Administration of pneumococcal vaccine	45	41	$48.00	$20.24
90670 Pneumococcal vaccine for injection into muscle	33	32	$206.97	$195.50
87804 Detection test by immunoassay with direct visual observation for influenza virus	28	18	$55.00	$16.22
20610 Aspiration and/or injection of fluid from large joint	25	20	$122.00	$57.20
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	20	17	$285.00	$183.78
99238 Hospital discharge day management, 30 minutes or less	17	17	$102.00	$64.99
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	15	11	$137.00	$85.84
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	12	12	$132.00	$105.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	720	285	$150.00	$98.99
99213 Established patient office or other outpatient visit, typically 15 minutes	460	208	$98.00	$67.52
85610 Blood test, clotting time	353	26	$20.00	$5.28
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	251	37	$29.00	$18.62
G0008 Administration of influenza virus vaccine	201	200	$28.00	$24.62
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	201	201	$54.00	$23.57
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	166	107	$61.00	$40.27
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	97	26	$102.00	$66.77
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	77	64	$202.00	$133.61
93000 Routine ekg using at least 12 leads including interpretation and report	62	52	$45.00	$15.68
81003 Automated urinalysis test	48	39	$25.00	$3.02
G0009 Administration of pneumococcal vaccine	47	46	$48.00	$24.99
20610 Aspiration and/or injection of fluid from large joint	36	27	$122.00	$53.67
90670 Pneumococcal vaccine for injection into muscle	35	35	$195.00	$184.25
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	31	23	$285.00	$187.42
99238 Hospital discharge day management, 30 minutes or less	29	23	$102.00	$67.03
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	29	14	$147.00	$96.44
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	12	12	$132.00	$93.96

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License VA 0101225016

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

1083702385 (VA)

Hospital & Practice Group Affiliations

Direct Access Internal Medicine Ltd

6609 Main St, Gloucester, VA 230615194

Phone: 8048249153

Rappahannock Westminster-Canterbury, Inc.

132 Lancaster Dr, Irvington, VA 224809740

Phone: 8044384000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Dr. Lindsey Williams , DO

Internal Medicine

NPI 1487340782

Doctor of Osteopathic Medicine (D.O.)

Blair Nein , NP

Family Medicine - Adult Medicine

NPI 1679165823

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active December 02, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location December 02, 2015

Registered at 6609 MAIN ST, GLOUCESTER, VA 230615194 (Tel: 8048249153)

📍

Updated Business Mailing Address December 02, 2015

Registered at 6609 MAIN ST, GLOUCESTER, VA 230615194 (Tel: 8048249153)

👤

Provider Name / Credentials Updated December 02, 2015

Recorded as RONALD HAGGERTY, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 02, 2015

Internal Medicine (License #0101225016 in VA)

🟢

Initial NPI Registration & Enumeration October 11, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1083702385

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 11, 2006

Last Update: December 02, 2015

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

6609 Main St

Gloucester, VA 230615194

Phone: 8048249153

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.