CENTRA MEDICAL GROUP, LLC (NPI# 1295104347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295104347 |
| Entity Type | Organization |
| Organization Name | CENTRA MEDICAL GROUP, LLC |
| Other Organization Name | CENTRA MEDICAL GROUP BEDFORD |
| Practice Address |
1613 Oakwood St Suite 201 Bedford VA 24523-1213 |
| Mailing Address |
2010 Atherholt Rd Lynchburg VA 24501-1106 |
| Practice Telephone | 5405867273 |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2015-09-18 |
| Authorized Official Name | JOSEPH KOONS (MANAGING DIRECTOR) |
| 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 |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Centra Medical Group Bedford | 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 |
| 1720463821 | Centra Medical Group, LLC | Psychiatry & Neurology | 1933 Thomson Dr, Lynchburg, VA 24501-1008 | 2015-07-30 |
| Street Address |
1613 OAKWOOD ST SUITE 201 |
| City | BEDFORD |
| State | VA |
| Zip Code | 24523-1213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295728491 | Bedford Memorial Hospital | General Acute Care Hospital | 1613 Oakwood St, Bedford, VA 24523-1213 | 2005-08-24 |
| 1053878587 | Mary Kate Manuel | Physical Medicine & Rehabilitation | 1613 Oakwood St, Bedford, VA 24523-1213 | 2019-02-20 |
| 1659813285 | Wendy Learn | Physical Therapist | 1613 Oakwood St, Bedford, VA 24523-1213 | 2016-11-14 |
| 1568821312 | Jennifer Meade | Occupational Therapist | 1613 Oakwood St, Bedford, VA 24523-1213 | 2016-02-22 |
| 1043608029 | Justin Seward | Physical Therapist | 1613 Oakwood St, Bedford, VA 24523-1213 | 2014-12-29 |
| 1235534702 | Shelia Schroeder | Occupational Therapist | 1613 Oakwood St, Bedford, VA 24523-1213 | 2014-10-27 |
| 1902209968 | Bryce Bristow | Speech-Language Pathologist | 1613 Oakwood St, Bedford, VA 24523-1213 | 2014-10-06 |
| 1386057420 | Bedford Post Acute Services LLC | Nursing Facility/Intermediate Care Facility | 1613 Oakwood St, Bedford, VA 24523-1213 | 2014-06-06 |
| 1699194977 | Centra Medical Group Bedford, LLC | Anesthesiology | 1613 Oakwood St, Bedford, VA 24523-1213 | 2014-04-15 |
| 1588918239 | Kelly P Dinh | Physician Assistant | 1613 Oakwood St, Bedford, VA 24523-1213 | 2012-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952912107 | Mary Hunter T Barrow | Speech-Language Pathologist | 301 South Bridge St, Bedford, VA 24523 | 2020-08-12 |
| 1578196127 | Professional Therapies of Roanoke Inc. | Clinic/Center | 1380 American Way Court, Unit C, Bedford, VA 24523 | 2020-02-21 |
| 1982242202 | Andrew Jason White | Occupational Therapist | 1229 Country Farm Rd, Bedford, VA 24523 | 2019-12-17 |
| 1841704590 | Bosang & Chandler, Inc. | Registered Nurse | 2003 Joseph's Way, Bedford, VA 24523 | 2017-11-16 |
| 1720534944 | Courtney Wills | Community Health Worker | 1012 Laurel Street, Bedford, VA 24523 | 2016-08-28 |
| 1255710547 | Family Preservation Services, Inc | Community/Behavioral Health | 1059 Turning Point Road, Bedford, VA 24523 | 2015-05-20 |
| 1780082388 | Americare Plus, LLC | In Home Supportive Care | 118 South Bridge Street, Bedford, VA 24523 | 2014-12-12 |
| 1962764076 | Jared Paul Quesenberry | Optometrist | 1332 Lowry St, Suite A, Bedford, VA 24523 | 2012-06-13 |
| 1336379049 | Judith Ann Bair | Social Worker | 1105 Maiden Lane, Bedford, VA 24523 | 2009-07-16 |
| 1770662272 | Pamela L Thompson | Physical Therapist | 1364 American Way Village, Heartland Rehabilitation Services of Virginia Inc, Bedford, VA 24523 | 2006-11-03 |
| Find all providers in zip 24523 | ||||
| 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 |
|---|---|---|---|---|
| 1437585197 | Gordon Edward Carruthers | Family Medicine | 14 Appleby Dr, Bedford, NY 10506 | 2013-09-25 |
| 1477799435 | First You Physician House Calls Psc | Family Medicine | 18 Alexander Ave Unit 1, Bedford, KY 40006-1114 | 2008-12-22 |
| 1396909651 | Glendal Ray Dow | Family Medicine | 1320 Hardisty Rd, Bedford, TX 76021-6522 | 2008-07-16 |
| 1770784308 | Dunn Memorial Hospital | Family Medicine | 1620 25th St, Bedford, IN 47421-5000 | 2007-05-30 |
| 1225242886 | Bedford Family Medicine, Pa | Family Medicine | 1701 Forest Ridge Dr., Bedford, TX 76022 | 2007-05-10 |
| 1750420303 | Ruth D Jones | Family Medicine | 342 S Richard St, Bedford, PA 15522-1743 | 2007-02-06 |
| 1841358876 | First You Medical Center Pllc | Family Medicine | 18 Alexander Ave, Unit 1, Bedford, KY 40006-1114 | 2006-12-04 |
| 1285708511 | Trimble Family Practice, LLC | Family Medicine | 470 Highway 421, Bedford, KY 40006-0247 | 2006-11-20 |
| 1346321262 | Deborah Brindza | Family Medicine | 22750 Rockside Rd Ste 210, Bedford, OH 44146-1576 | 2006-10-18 |
| 1982794020 | Leonard Joel Cohen | Family Medicine | 582 Blue Ridge Ave., Bedford, VA 24523 | 2006-10-12 |
| Find all providers in BEDFORD | ||||
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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.