CENTRA MEDICAL GROUP, LLC (NPI# 1376033886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376033886 |
| Entity Type | Organization |
| Organization Name | CENTRA MEDICAL GROUP, LLC |
| Other Organization Name | CMG CRITICAL CARE |
| Practice Address |
1901 Tate Springs Rd Lynchburg VA 24501-1109 |
| Mailing Address |
1937 Thomson Dr Lynchburg VA 24501-1008 |
| Practice Telephone | 4342002925 |
| Mailing Telephone | 4342005047 |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2018-05-10 |
| Authorized Official Name | JOSHUA LARKIN (PAYER CREDENTIALING MANAGER) |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| CMG Critical Care | 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 |
| 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 |
| 1720463821 | Centra Medical Group, LLC | Psychiatry & Neurology | 1933 Thomson Dr, Lynchburg, VA 24501-1008 | 2015-07-30 |
| Street Address |
1901 TATE SPRINGS RD |
| City | LYNCHBURG |
| State | VA |
| Zip Code | 24501-1109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063415982 | John W Demarino Jr. | Anesthesiology | 1901 Tate Springs Rd, Lynchburg, VA 24501-1109 | 2005-05-24 |
| 1578160511 | John Campbell Holcomb | Nurse Practitioner | 1901 Tate Springs Rd, Lynchburg, VA 24501-1109 | 2020-10-02 |
| 1992312789 | Ragan Scott | Nurse Practitioner | 1901 Tate Springs Rd, Lynchburg, VA 24501-1109 | 2020-09-25 |
| 1154930022 | Angela E Shearer | Nurse Practitioner | 1901 Tate Springs Rd, Lynchburg, VA 24501-1109 | 2020-07-27 |
| 1144848375 | Erin Leah Clara Jones | Physician Assistant | 1901 Tate Springs Rd, Lynchburg, VA 24501-1109 | 2020-07-14 |
| 1043836828 | Laura D Winch | Occupational Therapist | 1901 Tate Springs Rd, Lynchburg, VA 24501-1109 | 2020-06-17 |
| 1194347781 | William Lee Pearce | Nurse Anesthetist, Certified Registered | 1901 Tate Springs Rd, Lynchburg, VA 24501-1109 | 2020-05-18 |
| 1326660721 | Shane Michael Clary | Registered Nurse | 1901 Tate Springs Rd, Lynchburg, VA 24501-1109 | 2020-05-08 |
| 1770110280 | Brian Robert Harder | Physical Therapist | 1901 Tate Springs Rd, Lynchburg, VA 24501-1109 | 2020-03-25 |
| 1154958585 | Allyson Danielle Brasseur | Nurse Anesthetist, Certified Registered | 1901 Tate Springs Rd, Lynchburg, VA 24501-1109 | 2020-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720606957 | Evidence Based Counseling Solutions | Speech-Language Pathologist | 302 Oakley Ave, Lynchburg, VA 24501 | 2020-07-14 |
| 1740805506 | Ryan Buschmann | Physical Therapist | 2400 Lakeside Drivve, Suite 602f, Lynchburg, VA 24501 | 2020-06-08 |
| 1528525276 | Julia M Mcauley-gonzalez | Nurse Practitioner | Cvfp Immediate Care - Airport, 14005 Wards Rd - Suite A, Lynchburg, VA 24501 | 2019-02-28 |
| 1548732795 | Morgan Rose Nails | Chiropractor | 3012 Forest Hills Circle, Lynchburg, VA 24501 | 2018-12-28 |
| 1407346935 | Belva Shelor | Psychologist | 1201 Floyd Street, Lynchburg, VA 24501 | 2018-05-10 |
| 1770092447 | Bio-medical Applications of Virginia, Inc. | Clinic/Center | 3204 Old Forest Rd, Lynchburg, VA 24501 | 2017-09-26 |
| 1447774518 | Restoring Peace Counseling Services | Clinic/Center | 3311 Old Forest Rd Ste 101, Lynchburg, VA 24501 | 2017-08-01 |
| 1427578335 | Vinh Thinh T Huynh | Family Medicine | 2323 Memorial Avenue, Suite #10, Lynchburg, VA 24501 | 2017-06-21 |
| 1811436769 | Jordan Legendre | Student in an Organized Health Care Education/Training Program | 2900 Weeping Willow Drive, Apt. I, Lynchburg, VA 24501 | 2017-02-13 |
| 1114465861 | Shanika Harris | Specialist/Technologist | 1501 Lakeside Drive, Lynchburg, VA 24501 | 2017-02-02 |
| Find all providers in zip 24501 | ||||
| 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 |
|---|---|---|---|---|
| 1134737265 | Joshua Fleming | Family Medicine | 1125 Old Graves Mill Rd Apt 316, Lynchburg, VA 24502-4312 | 2020-07-15 |
| 1124640529 | Deborah Armstrong Md PC | Family Medicine | 300 Two Creek Dr, Lynchburg, VA 24502-5140 | 2020-05-08 |
| 1477048973 | Ptc Wellness Centers Bwxt | Family Medicine | 1570 Mt. Athos Rd., Lynchburg, VA 24504 | 2018-06-27 |
| 1023503521 | Ptc Wellness Centers PC | Family Medicine | 2832 Candlers Mtn Rd, Lynchburg, VA 24502 | 2018-06-27 |
| 1427578335 | Vinh Thinh T Huynh | Family Medicine | 2323 Memorial Avenue, Suite #10, Lynchburg, VA 24501 | 2017-06-21 |
| 1164845632 | Andrew Joseph Anderson | Family Medicine | 4327 Boonsboro Rd Ste 5, Lynchburg, VA 24503 | 2014-02-03 |
| 1013356542 | Anoop Singh Kochar | Family Medicine | 2323 Memorial Avenue Suite #10, Lynchburg Family Medicine Residency, Lynchburg, VA 24501 | 2013-06-18 |
| 1669610986 | Central Virginia Family Physicians, Inc | Family Medicine | 14005 Wards Rd, #a, Lynchburg, VA 24501-7127 | 2009-01-23 |
| 1346486560 | Centra Health Professional Services, LLC | Family Medicine | 1902 Grace St, Lynchburg, VA 24504-3524 | 2008-12-17 |
| 1376732818 | Rafal Piotr Kaczynski | Family Medicine | 1900 Weeping Willow Dr Apt J, Lynchburg, VA 24501-3966 | 2007-10-22 |
| Find all providers in LYNCHBURG | ||||
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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.