CENTRA MEDICAL GROUP, LLC (NPI# 1013031368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013031368 |
| Entity Type | Organization |
| Organization Name | CENTRA MEDICAL GROUP, LLC |
| Other Organization Name | CENTRA HEALTH MEDICAL CENTER-GRETNA RHC |
| Practice Address |
291 Mcbride Ln Gretna VA 24557-2773 |
| Mailing Address |
2010 Atherholt Rd Lynchburg VA 24501-1106 |
| Practice Telephone | 4346561274 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2015-11-17 |
| Authorized Official Name | JOSEPH KOONS (MANAGING DIRECTOR REVENUE CYCLE) |
| Authorized Official Telephone | 4342005047 |
| Is Organization Subpart | Y |
| Parent Organization Name | CENTRA MEDICAL GROUP, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Centra Health Medical Center-Gretna RHC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326682980 | Centra Medical Group, LLC | Family Medicine | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2019-11-06 |
| 1144880782 | Centra Medical Group, LLC | Surgery | 2410 Atherholt Rd, Lynchburg, VA 24501-2148 | 2019-06-17 |
| 1932685526 | Centra Medical Group, LLC | Anesthesiology | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2018-07-17 |
| 1548750052 | Centra Medical Group, LLC | Family Medicine | 1901 Tate Springs Rd, Lynchburg, VA 24501-1109 | 2018-05-10 |
| 1376033886 | Centra Medical Group, LLC | Family Medicine | 1901 Tate Springs Rd, Lynchburg, VA 24501-1109 | 2018-05-10 |
| 1912434663 | Centra Medical Group, LLC | Family Medicine | 2010 Atherholt Rd, Lynchburg, VA 24501-1106 | 2017-05-12 |
| 1518315902 | Centra Medical Group, LLC | Clinic/Center | 125 Nationwide Drive, Lynchburg, VA 24502-9998 | 2016-05-26 |
| 1649624164 | Centra Medical Group, LLC | Psychologist | 2010 Atherholt Rd, Lynchburg, VA 24501-1106 | 2016-04-21 |
| 1003260522 | Centra Medical Group, LLC | Anesthesiology | 2010 Atherholt Rd, Lynchburg, VA 24501-1106 | 2016-04-21 |
| 1295104347 | Centra Medical Group, LLC | Internal Medicine | 1613 Oakwood St, Suite 201, Bedford, VA 24523-1213 | 2015-09-18 |
| Street Address |
291 MCBRIDE LN |
| City | GRETNA |
| State | VA |
| Zip Code | 24557-2773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609873009 | Pamela G. Smith | Internal Medicine | 291 Mcbride Ln, Gretna, VA 24557-2773 | 2005-06-30 |
| 1124587282 | Amber Mckinney | Physical Therapist | 291 Mcbride Ln, Gretna, VA 24557-2773 | 2019-03-18 |
| 1790240380 | Michelle Fuquay Beale | Nurse Practitioner | 291 Mcbride Ln, Gretna, VA 24557-2773 | 2019-02-07 |
| 1528580164 | Anne Saunier | Nurse Practitioner | 291 Mcbride Ln, Gretna, VA 24557-2773 | 2017-07-14 |
| 1437606340 | Andrew Lee Quinn Jr. | Nurse Practitioner | 291 Mcbride Ln, Gretna, VA 24557-2773 | 2016-09-08 |
| 1407303852 | Melissa Coleman | Nurse Practitioner | 291 Mcbride Ln, Gretna, VA 24557-2773 | 2016-09-01 |
| 1922374214 | Brenden M Burkholder | Internal Medicine | 291 Mcbride Ln, Gretna, VA 24557-2773 | 2012-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669013207 | Patricia Ann Marshall | Technician | 590 Island Point Dr., Gretna, VA 24557 | 2019-10-04 |
| 1598932394 | Gretna Rescue Squad Inc | Ambulance | 102 East Gretna Road, Gretna, VA 24557 | 2008-05-12 |
| 1770008708 | Brendle Crews Stone | Driver | 536 Hodnetts Rd, Gretna, VA 24557 | 2017-08-10 |
| 1215022496 | Michael Lee Bond | Dentist | 603 S Main St, Gretna, VA 24557 | 2006-10-04 |
| 1770957995 | Tracy Overstreet Garrett | Nurse Practitioner | 291 Mcbride Lane, Gretna, VA 24557-0000 | 2015-11-27 |
| 1407256274 | Centra Health, Inc. | General Acute Care Hospital | 291 Mccbride Lane, Gretna, VA 24557-0291 | 2014-08-29 |
| 1578800181 | Thomas D Morris | Pharmacist | 108 Vaden Drive, Gretna, VA 24557-0456 | 2013-01-16 |
| 1578089819 | Terry Callands | Driver | 545 Telegraph Rd, Gretna, VA 24557-1777 | 2017-08-18 |
| 1649226572 | Doss Estates, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 860 Piney Grove Rd, Gretna, VA 24557-1843 | 2006-05-25 |
| 1689199747 | Joseph Chambers | Driver | 2517 Hodnetts Rd, Gretna, VA 24557-1928 | 2017-08-10 |
| Find all providers in zip 24557 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508077603 | Danville Physician Practices, LLC | Clinic/Center | 305 N Main St, Gretna, VA 24557-4176 | 2007-05-24 |
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|---|---|---|---|---|
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| 1457840183 | Warren Memorial Hospital, Inc. | Clinic/Center | 315 W 10th St Ste 1, Front Royal, VA 22630-2812 | 2018-05-08 |
| 1154857019 | Bath County Community Hospital | Clinic/Center | 713 S Monroe Ave, Covington, VA 24426-1832 | 2017-05-11 |
| 1891154019 | Appalachian Regional Healthcare, Inc. | Clinic/Center | 121 Stacy Dr, Pennington Gap, VA 24277-1929 | 2016-02-16 |
| 1366791972 | Free Clinic of Franklin County | Clinic/Center | 1171 Franklin Street, Rocky Mount, VA 24151 | 2012-08-29 |
| 1487818902 | St. Mary's Health Wagon | Clinic/Center | 233 Chase St., Clintwood, VA 24228 | 2008-07-14 |
| 1609054733 | Mountain States Health Alliance | Clinic/Center | 16431 Wise Street, Saint Paul, VA 24283-3537 | 2008-01-31 |
| 1013199322 | Page Memorial Hospital, Inc. | Clinic/Center | 505 Williams Ave, Shenandoah, VA 22849-1263 | 2007-11-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.