CENTRA HEALTH PROFESSIONAL SERVICES, LLC (NPI# 1235480351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235480351 |
| Entity Type | Organization |
| Organization Name | CENTRA HEALTH PROFESSIONAL SERVICES, LLC |
| Other Organization Name | CHILD/ADOLESCENT PSYCH PROGRAM |
| Practice Address |
3300 Rivermont Ave Lynchburg VA 24503-2030 |
| Mailing Address |
1204 Fenwick Dr Lynchburg VA 24502-2112 |
| Practice Telephone | 4342005999 |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2012-09-28 |
| Authorized Official Name | LEWIS ADDISON (CFO) |
| Authorized Official Telephone | 4342003656 |
| Is Organization Subpart | Y |
| Parent Organization Name | CENTRA HEALTH PROFESSIONAL SERVICES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Child/Adolescent Psych Program | 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 |
| 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 |
| 1881979342 | Centra Health Professional Services, LLC | Psychiatry & Neurology | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2011-10-17 |
| Street Address |
3300 RIVERMONT AVE |
| City | LYNCHBURG |
| State | VA |
| Zip Code | 24503-2030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750384137 | James Cummings Dunstan Jr. | Orthopaedic Surgery | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2005-05-31 |
| 1649887175 | Bruce Slagle | Pharmacy Technician | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2020-09-29 |
| 1023622149 | Stephanie Lane Porter | Nurse Practitioner | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2020-09-04 |
| 1013532803 | Meredith Ryan Smith | Counselor | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2020-06-08 |
| 1326682980 | Centra Medical Group, LLC | Family Medicine | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2019-11-06 |
| 1831751809 | Elizabeth Ware | Speech-Language Pathologist | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2019-07-01 |
| 1730740788 | Rhandi Nichole Norman | Registered Nurse | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2019-06-20 |
| 1922668136 | Paula Deane Creekmore | Nurse Practitioner | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2019-06-19 |
| 1215401948 | Adam Russell Penrose | Nurse Anesthetist, Certified Registered | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2019-01-16 |
| 1891268199 | Donna C Schwarz | Nurse Anesthetist, Certified Registered | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2019-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427661859 | Better Way Psychiatry Pllc | Psychiatry & Neurology | 4925 Boonsboro Road, Pmb 137, Lynchburg, VA 24503 | 2020-08-25 |
| 1164845632 | Andrew Joseph Anderson | Family Medicine | 4327 Boonsboro Rd Ste 5, Lynchburg, VA 24503 | 2014-02-03 |
| 1407139421 | William Carter Wingfield Sr. | Pharmacist | 5006 Old Boonsboro Rd, Lynchburg, VA 24503 | 2011-09-26 |
| 1912226382 | The Way Congregational Church | Voluntary or Charitable | 3305 Rivermont Avenue, Lynchburg, VA 24503 | 2010-05-25 |
| 1659549897 | Elizabeth Ann Bolton | Speech-Language Pathologist | 302 Rowland Dr., Lynchburg, VA 24503 | 2008-02-11 |
| 1821286485 | Mary Ayers Highton | Nurse Practitioner | 3300 Rivermont Ave., Lynchburg, VA 24503 | 2007-10-09 |
| 1588746044 | Presbyterian Homes and Family Services | Day Training, Developmentally Disabled Services | 150 Linden Avenue, Lynchburg, VA 24503 | 2006-10-20 |
| 1417043910 | Timothy Clinton | Counselor | 2811 Linkhorne Dr., Ste B, Lynchburg, VA 24503 | 2006-10-04 |
| 1730733288 | Joy Lois Knapton | Lactation Consultant, Non-RN | 150 Linden Ave, Lynchburg, VA 24503 | 2019-08-01 |
| 1346606845 | Julie Brown | Registered Nurse | 3300 Rivermont Ave., Virginia Baptist Hospital, Lynchburg, VA 24503 | 2016-01-13 |
| Find all providers in zip 24503 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831592369 | Onaiza Anees | Psychiatry & Neurology | 2215 Langhorne Rd, Lynchburg, VA 24501-1121 | 2014-09-29 |
| 1083908958 | Jitendra Annapareddy | Psychiatry & Neurology | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2011-06-08 |
| 1134364151 | Namita Dhiman | Psychiatry & Neurology | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2008-12-04 |
| 1750547915 | Lakshman Sudhir Gandham | Psychiatry & Neurology | 3300 Rivermont Ave, Lynchburg, VA 24503 | 2008-08-06 |
| 1154517670 | Tiffany Kuulei Niide | Psychiatry & Neurology | 2010 Atherholt Rd, Lynchburg, VA 24501-1106 | 2007-09-18 |
| 1154412344 | James G Kavanaugh Jr. | Psychiatry & Neurology | 2215 Langhorne Rd, Suite 104, Lynchburg, VA 24501-1121 | 2006-09-27 |
| 1609818293 | Centra Medical Group, LLC | Psychiatry & Neurology | 693 Leesville Rd, Lynchburg, VA 24502-2828 | 2006-06-11 |
| 1366443434 | Edward John Kuhnley | Psychiatry & Neurology | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2005-08-10 |
| 1699775593 | John L. Hendrickson | Psychiatry & Neurology | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2005-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902248073 | Tanvir Iqbal | Psychiatry & Neurology | 201 S Main St Ste 3400, Danville, VA 24541-2932 | 2013-07-18 |
| 1821364043 | Michael Kubelik Heck | Psychiatry & Neurology | 691 Berkmar Cir, Charlottesville, VA 22901-1464 | 2012-04-02 |
| 1831403864 | Neel Nene | Psychiatry & Neurology | 801 N Quincy St Ste 601, Arlington, VA 22203-1729 | 2010-08-02 |
| 1295048684 | My Psychiatrist, Plc | Psychiatry & Neurology | 12359 Sunrise Valley Dr Ste 320, Herndon, VA 20191-3463 | 2010-07-14 |
| 1023257979 | Kevin Michael Williams | Psychiatry & Neurology | 3737 Seminary Rd, Alexandria, VA 22304-5202 | 2009-02-17 |
| 1881854982 | John Paul Steg | Psychiatry & Neurology | 6760 Old Mclean Village Dr, Mc Lean, VA 22101-3906 | 2008-06-11 |
| 1336343516 | Nelson Lugo | Psychiatry & Neurology | 43330 Junction Plz Ste 160, Pmb 108, Ashburn, VA 20147-3408 | 2007-06-12 |
| 1598973471 | Charles E Hall Iv | Psychiatry & Neurology | 100 Boulders Pkwy, Suite 202, Richmond, VA 23225 | 2007-05-21 |
| 1699983692 | Heather Kilbride Henig | Psychiatry & Neurology | 11490 Commerce Park Dr Ste 420, Reston, VA 20191 | 2007-05-21 |
| 1104942754 | William Louis Licamele | Psychiatry & Neurology | 6760 Old Mclean Village Dr., Mclean, VA 22101-3906 | 2007-03-22 |
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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.