CENTRA MEDICAL GROUP, LLC (NPI# 1831357979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831357979 |
| Entity Type | Organization |
| Organization Name | CENTRA MEDICAL GROUP, LLC |
| Other Organization Name | CENTRA MEDICAL GROUP UROLOGH |
| Practice Address |
1330 Oak Ln Suite 203 Lynchburg VA 24503-2513 |
| Mailing Address |
2010 Atherholt Rd Lynchburg VA 24501-1106 |
| Practice Telephone | 4342006620 |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2014-04-10 |
| Authorized Official Name | LEWIS ADDISON (SR VP CFO) |
| 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 | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Centra Medical Group Urologh | 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 |
| 1295104347 | Centra Medical Group, LLC | Internal Medicine | 1613 Oakwood St, Suite 201, Bedford, VA 24523-1213 | 2015-09-18 |
| Street Address |
1330 OAK LN SUITE 203 |
| City | LYNCHBURG |
| State | VA |
| Zip Code | 24503-2513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225035520 | Carole Stephens Read | Audiologist | 1330 Oak Ln, Suite 204, Lynchburg, VA 24503-2513 | 2005-06-30 |
| 1538584800 | Centra Medical Group, LLC | Plastic Surgery | 1330 Oak Ln, Suite 100, Lynchburg, VA 24503-2513 | 2014-02-24 |
| 1497919740 | Keith Dwayne Pitzer | Plastic Surgery | 1330 Oak Ln, Suite 100, Lynchburg, VA 24503-2513 | 2008-07-16 |
| 1558496117 | Henry B Wilson | Specialist | 1330 Oak Ln, Suite 100, Lynchburg, VA 24503-2513 | 2007-02-23 |
| 1265572945 | Judith A. Perrotto | Radiology | 1330 Oak Ln, Lynchburg, VA 24503-2513 | 2007-02-08 |
| 1942376579 | Centra Health, Inc. | Radiology | 1330 Oak Ln, Lynchburg, VA 24503-2513 | 2006-11-27 |
| 1831272103 | Central Virginia Audiology Services Inc | Audiologist | 1330 Oak Ln, Suite 204, Lynchburg, VA 24503-2513 | 2006-10-23 |
| 1174614416 | Plastic Surgery Associates of Lynchburg, Inc. | Plastic Surgery | 1330 Oak Ln, Suite 100, Lynchburg, VA 24503-2513 | 2006-09-28 |
| 1558466201 | Mark Douglas Macgregor | Physician Assistant | 1330 Oak Ln, Ste 101, Lynchburg, VA 24503-2513 | 2006-09-14 |
| 1033120852 | Sebastian J Ksionski | Family Medicine | 1330 Oak Ln, Lynchburg, VA 24503 | 2006-08-10 |
| 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 |
| 1437606092 | Deborah Opsal | Speech-Language Pathologist | 3300 Rivermont Ave, Outpatient Rehab Administration, Lynchburg, VA 24503 | 2016-09-01 |
| Find all providers in zip 24503 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124047212 | Steven Koziol | Urology | 2542 Langhorne Rd, Lynchburg, VA 24501-1602 | 2006-07-19 |
| 1912310723 | Sara L Valente | Urology | 2542 Langhorne Rd, Lynchburg, VA 24501-1602 | 2014-06-09 |
| 1023299781 | Centra Health Professional Services, LLC | Urology | 2542 Langhorne Rd, Lynchburg, VA 24501-1602 | 2007-11-21 |
| 1316157761 | Corey Passman | Urology | 2542 Langhorne Rd, Lynchburg, VA 24501-1602 | 2007-05-23 |
| 1023228483 | Christopher Stands | Urology | 2542 Langhorne Rd, Lynchburg, VA 24501-1602 | 2007-05-23 |
| 1639265648 | Ronald James Fisher | Urology | 2542 Langhorne Rd, Lynchburg, VA 24501-1602 | 2006-10-05 |
| 1336235290 | Seven Hills Urology Center, Inc. | Urology | 2542 Langhorne Rd, Lynchburg, VA 24501-1602 | 2006-10-05 |
| 1437243177 | R. Dean Clower | Urology | 2542 Langhorne Rd, Lynchburg, VA 24501-1602 | 2006-10-03 |
| 1851485411 | Kevin Finnie Green | Urology | 2542 Langhorne Rd, Lynchburg, VA 24501-1602 | 2006-10-03 |
| 1053405787 | David W Leffke | Urology | 2542 Langhorne Rd, Lynchburg, VA 24501-1602 | 2006-10-03 |
| 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.