CENTRA MEDICAL GROUP, LLC


Address: 693 Leesville Rd, Lynchburg, VA 24502-2828
Phone: 4342005700

CENTRA MEDICAL GROUP, LLC (NPI# 1609818293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609818293
Entity Type Organization
Organization Name CENTRA MEDICAL GROUP, LLC
Other Organization Name AUTISM DIAGNOSTIC CENTER
Practice Address 693 Leesville Rd
Lynchburg
VA 24502-2828
Mailing Address 2010 Atherholt Rd
Lynchburg
VA 24501-1106
Practice Telephone 4342005700
Enumeration Date 2006-06-11
Last Update Date 2014-01-15
Authorized Official Name LEWIS ADDISON (SR VP CFO)
Authorized Official Telephone 4342005047
Is Organization Subpart Y
Parent Organization Name CENTRA MEDICAL GROUP, LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084P0804X Psychiatry & Neurology
Specialization: Child & Adolescent Psychiatry
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Autism Diagnostic Center Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 693 LEESVILLE RD
City LYNCHBURG
State VA
Zip Code 24502-2828

Providers in the same location

NPI Name Taxonomy Address Enumeration
1215938972 Ellis M. Karr Social Worker 693 Leesville Rd, Lynchburg, VA 24502-2828 2005-08-03
1376144931 Nelly Addo Behavior Technician 693 Leesville Rd, Lynchburg, VA 24502-2828 2020-11-02
1366057531 Margaret Rose Hybl Behavior Technician 693 Leesville Rd, Lynchburg, VA 24502-2828 2020-09-14
1427662261 Samantha Clingenpeel Behavior Technician 693 Leesville Rd, Lynchburg, VA 24502-2828 2020-08-31
1952915712 Jessica Stinnett Cunningham Behavior Technician 693 Leesville Rd, Lynchburg, VA 24502-2828 2020-08-31
1346850948 Nikki Rice Behavior Technician 693 Leesville Rd, Lynchburg, VA 24502-2828 2020-08-07
1912516642 Stephannie Malone Behavior Technician 693 Leesville Rd, Lynchburg, VA 24502-2828 2020-07-29
1265041552 Jeffrey Emmett Mccurry Behavior Technician 693 Leesville Rd, Lynchburg, VA 24502-2828 2020-07-23
1164044863 Amanda Mae Dinkle Behavior Technician 693 Leesville Rd, Lynchburg, VA 24502-2828 2020-05-15
1366063026 Heather Ware Behavioral Analyst 693 Leesville Rd, Lynchburg, VA 24502-2828 2020-05-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1811523038 Vivian Tran Student in an Organized Health Care Education/Training Program Liberty University College of Osteopathic Medicine, 306 Liberty View Ln, Lynchburg, VA 24502 2020-03-19
1669005468 Beth Elaine Hammond Nurse Practitioner 132 Frederick Drive, Lynchburg, VA 24502 2020-02-20
1225672348 Pearlren-aye Elizabeth Taylor Case Management 542 Leesville Rd, Apt 127, Lynchburg, VA 24502 2019-10-31
1821553868 Shavonne D Joyner Behavioral Analyst 18697 Forest Road, Lynchburg, VA 24502 2019-02-04
1043794415 Robert Patrick Thomas Private Vehicle 44 Point Drive, Apt 30, Lynchburg, VA 24502 2018-09-20
1023503521 Ptc Wellness Centers PC Family Medicine 2832 Candlers Mtn Rd, Lynchburg, VA 24502 2018-06-27
1548750722 Raymond W Andrews IIi Speech-Language Pathologist 3101 Wards Ferry Road, Lynchburg, VA 24502 2018-05-14
1932697596 Barbara J Frost Nurse Practitioner 906 Westview Dr, Lynchburg, VA 24502 2018-04-28
1619476983 Benjamin Aaron Galley Specialist/Technologist 1971 University Blvd., Lynchburg, VA 24502 2018-02-01
1477076180 Candice Cage Home Health 1002 Wexford Place, Lynchburg, VA 24502 2017-07-25
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Taxonomy Information

Taxonomy Code 2084P0804X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Child & Adolescent Psychiatry

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1831592369 Onaiza Anees Psychiatry & Neurology 2215 Langhorne Rd, Lynchburg, VA 24501-1121 2014-09-29
1235480351 Centra Health Professional Services, LLC Psychiatry & Neurology 3300 Rivermont Ave, Lynchburg, VA 24503-2030 2012-09-28
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
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

Providers in the same taxonomy and state

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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Competitor

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City LYNCHBURG
Zip Code 24502

Improve Information

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Dataset Information

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.

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