CENTRA HEALTH PROFESSIONAL SERVICES, LLC (NPI# 1093750861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093750861 |
| Entity Type | Organization |
| Organization Name | CENTRA HEALTH PROFESSIONAL SERVICES, LLC |
| Other Organization Name | CENTRA HEALTH MEDICAL CENTER-GRETNA |
| Practice Address |
1220 W Gretna Rd Gretna VA 24557-4087 |
| Mailing Address |
1204 Fenwick Dr Lynchburg VA 24502-2112 |
| Practice Telephone | 4346561274 |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2008-03-04 |
| Authorized Official Name | TAMMY TWEEDY (DIRECTOR) |
| Authorized Official Telephone | 4349475047 |
| Is Organization Subpart | Y |
| Parent Organization Name | CENTRA HEALTH PROFESSIONAL SERVICES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Centra Health Medical Center-Gretna | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043662828 | Centra Health Professional Services, LLC | Internal Medicine | 414 Park Avenue, Danville, VA 24541-9998 | 2016-07-06 |
| 1760776447 | Centra Health Professional Services, LLC | Family Medicine | 10961 Lee Jackson Highway, Big Island, VA 24526 | 2011-05-31 |
| 1811135593 | Centra Health Professional Services, LLC | Physical Medicine & Rehabilitation | 404 Airport Dr, Suite C, Danville, VA 24540-5196 | 2009-02-03 |
| 1346486560 | Centra Health Professional Services, LLC | Family Medicine | 1902 Grace St, Lynchburg, VA 24504-3524 | 2008-12-17 |
| 1497900047 | Centra Health Professional Services, LLC | Urology | 1039 Mayberry Crossing Drive, Moneta, VA 24121 | 2008-11-24 |
| 1538101969 | Centra Health Professional Services, LLC | Physical Medicine & Rehabilitation | 1900 Tate Springs Rd, Suite 16, Lynchburg, VA 24501-1122 | 2006-06-11 |
| 1235480351 | Centra Health Professional Services, LLC | Psychiatry & Neurology | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2012-09-28 |
| 1316298433 | Centra Health Professional Services, LLC | Psychiatry & Neurology | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2012-09-28 |
| 1033471438 | Centra Health Professional Services, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1701 Thomson Dr, Lynchburg, VA 24501-1118 | 2012-06-12 |
| 1770840654 | Centra Health Professional Services, LLC | Orthopaedic Surgery | 1613 Oakwood St, Suite 101, Bedford, VA 24523-1213 | 2012-04-18 |
| Street Address |
1220 W GRETNA RD |
| City | GRETNA |
| State | VA |
| Zip Code | 24557-4087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841297678 | Violet P. Esposito | Registered Nurse | 1220 W Gretna Rd, Gretna, VA 24557-4087 | 2005-07-07 |
| 1942754791 | Tashan Duff | Physical Therapist | 1220 W Gretna Rd, Gretna, VA 24557-4087 | 2016-08-10 |
| 1972969871 | Centra Pace- Gretna | PACE Provider Organization | 1220 W Gretna Rd, Gretna, VA 24557-4087 | 2016-01-07 |
| 1811397359 | Kurtise Wilkes | Physical Therapist | 1220 W Gretna Rd, Gretna, VA 24557-4087 | 2014-09-03 |
| 1215343751 | Valerie Grimes | Physical Therapist | 1220 W Gretna Rd, Gretna, VA 24557-4087 | 2014-07-04 |
| 1245664390 | Jenifer Kelli Hoffert | Physician Assistant | 1220 W Gretna Rd, Gretna, VA 24557-4087 | 2013-08-26 |
| 1215215934 | Lakeshia Antoinette Entzminger | Internal Medicine | 1220 W Gretna Rd, Gretna, VA 24557-4087 | 2011-07-29 |
| 1659547339 | Joseph D Hostetler | Family Medicine | 1220 W Gretna Rd, Gretna, VA 24557-4087 | 2008-05-02 |
| 1215150768 | Renea Johnson Cooper | Physical Therapy Assistant | 1220 W Gretna Rd, Gretna, VA 24557-4087 | 2007-04-11 |
| 1861474629 | Shannon Marie Jones | Physical Therapist | 1220 W Gretna Rd, Gretna, VA 24557-4087 | 2005-11-17 |
| Find all providers in the same location | ||||
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255899936 | Deluxe Medical Corporation | Family Medicine | 3640 Lake Aspen Dr W, Gretna, LA 70056-8303 | 2019-03-12 |
| 1952747602 | Jefferson Medical Clinic LLC | Family Medicine | 435 Lapalco Blvd Ste 1, Gretna, LA 70056-7375 | 2013-05-21 |
| 1306080361 | Ngoc-thuy Thi Bui | Family Medicine | 435 Lapalco Blvd, Suite 1, Gretna, LA 70056-7375 | 2009-04-21 |
| 1336324573 | G A Romaguera Md LLC | Family Medicine | 316 Lafayette St., Gretna, LA 70053 | 2008-01-07 |
| 1821122342 | John Craig Cornett | Family Medicine | 1125 Newton St, Gretna, LA 70053-6339 | 2007-03-15 |
| 1104964758 | Janice S. Glenn, M.d. Ampc | Family Medicine | 2600 Belle Chasse Highway Ste 201a, Gretna, LA 70056-7156 | 2007-02-02 |
| 1831296102 | The Wellness Place PC | Family Medicine | 818 Village Sq., Gretna, NE 68028-7914 | 2006-09-20 |
| 1770691826 | Gerard A Romaguera | Family Medicine | 316 Lafayette St, Gretna, LA 70053 | 2006-08-28 |
| 1518916683 | Rafael A Cortes-moran | Family Medicine | 441 Wall Blvd., Gretna, LA 70056-7723 | 2006-05-08 |
| 1346207750 | Rufus Randolph Duffer | Family Medicine | 107 Henry St, Gretna, VA 24557-4177 | 2006-04-28 |
| Find all providers in GRETNA | ||||
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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.