CENTRA MEDICAL GROUP, LLC (NPI# 1013198779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013198779 |
Entity Type | Organization |
Organization Name | CENTRA MEDICAL GROUP, LLC |
Other Organization Name | CENTRA MEDICAL GROUP SURGICAL SPECIALISTS |
Practice Address |
1906 Thomson Dr Lynchburg VA 24501-1009 |
Mailing Address |
2010 Atherholt Rd Lynchburg VA 24501-1106 |
Practice Telephone | 4349473933 |
Enumeration Date | 2007-11-21 |
Last Update Date | 2014-10-16 |
Authorized Official Name | LEWIS ADDISON (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 | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
Y | 208C00000X | Colon & Rectal Surgery | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Centra Medical Group Surgical Specialists | 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 |
1906 THOMSON DR |
City | LYNCHBURG |
State | VA |
Zip Code | 24501-1009 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306890207 | William L Kittrell Jr. | Surgery | 1906 Thomson Dr, Central Virginia Surgery, Lynchburg, VA 24501-1009 | 2006-05-22 |
1932720117 | Stephanie Spina | Physician Assistant | 1906 Thomson Dr, Lynchburg, VA 24501-1009 | 2020-04-29 |
1144851502 | Allison Faye Mills | Surgery | 1906 Thomson Dr, Lynchburg, VA 24501-1009 | 2020-02-03 |
1124498399 | Sydney Ozmar | Physician Assistant | 1906 Thomson Dr, Lynchburg, VA 24501-1009 | 2015-10-01 |
1447631189 | Gabrielle Monique Rhodes Crawford | Nurse Practitioner | 1906 Thomson Dr, Lynchburg, VA 24501-1009 | 2015-06-17 |
1275732067 | Jennifer Erin Mihalik | Surgery | 1906 Thomson Dr, Lynchburg, VA 24501 | 2007-07-12 |
1982816427 | Joshua Benjamin Alley | Surgery | 1906 Thomson Dr, Lynchburg, VA 24501-1009 | 2007-05-04 |
1033271671 | The Orthopaedic Center of Central Virginia, Inc. | Durable Medical Equipment & Medical Supplies | 1906 Thomson Dr, Lynchburg, VA 24501-1009 | 2006-12-13 |
1538250709 | Lynchburg Surgical Associates, Inc. | Surgery | 1906 Thomson Dr, Lynchburg, VA 24501-1009 | 2006-09-27 |
1083658124 | Lucius Dubignon Clay IIi | Surgery | 1906 Thomson Dr, Lynchburg, VA 24501-1009 | 2006-06-16 |
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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 | 208C00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Colon & Rectal Surgery |
A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Colon and Rectal Surgery, 2007. http://www.abcrs.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Colon and Rectal Surgery. Colon and rectal surgeons have the expertise to diagnose and often manage anorectal conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum) in the office setting. They also treat problems of the intestine and colon, and perform endoscopic procedures to evaluate and treat problems such as cancer, polyps (precancerous growths) and inflammatory conditions. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073809281 | Mercy Danielle Wagner | Colon & Rectal Surgery | 260 John Paul Jones Cir, Portsmouth, VA 23708 | 2011-06-26 |
1497818025 | Chong S. Lee | Colon & Rectal Surgery | 155 Kinglsey Lane Suite 405, Bon Secours Surgical Specialists, Norfolk, VA 23505 | 2006-12-18 |
1427169507 | Fairfax Colon & Rectal Surgery, PC | Colon & Rectal Surgery | 2710 Propersity Ave, Ste 200, Fairfax, VA 22031 | 2006-08-31 |
1710918438 | Northern Virginia Surgical Group, PC | Colon & Rectal Surgery | 8316 Arlington Blvd., Suite 630, Fairfax, VA 22031-5216 | 2006-07-05 |
1720052285 | Gregory P Fitzharris | Colon & Rectal Surgery | 3000 Coliseum Dr Ste 200, Hampton, VA 23666-5963 | 2006-02-13 |
1356311286 | Paul Jerome Kovalcik | Colon & Rectal Surgery | 3105 American Legion Road, Suite A, Chesapeake, VA 23321-5653 | 2006-01-24 |
1396725636 | Beth Rachelle Jaklic | Colon & Rectal Surgery | 1301 First Colonial Rd Ste 201, Virginia Beach, VA 23454-2263 | 2006-01-20 |
1174525869 | Othon Wiltz | Colon & Rectal Surgery | 3620 Joseph Siewick Dr Ste 406, Fairfax, VA 22033-1761 | 2005-08-11 |
1598107674 | Virginia Hospital Center Physician Group, LLC | Colon & Rectal Surgery | 1625 N George Mason Dr, Suite 454, Arlington, VA 22205-3683 | 2013-07-18 |
1497092944 | Christina Cheng | Colon & Rectal Surgery | 2710 Prosperity Ave Ste 200, Fairfax, VA 22031-4358 | 2013-01-03 |
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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.