CENTRA HEALTH PROFESSIONAL SERVICES, LLC (NPI# 1245423201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245423201 |
| Entity Type | Organization |
| Organization Name | CENTRA HEALTH PROFESSIONAL SERVICES, LLC |
| Other Organization Name | CENTRA HEALTH BREAST SERVICES |
| Practice Address |
1901 Tate Springs Rd Lynchburg VA 24501-1109 |
| Mailing Address |
1204 Fenwick Dr Lynchburg VA 24502-2112 |
| Practice Telephone | 4349473090 |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2008-03-04 |
| Authorized Official Name | TAMMY TWEEDY (DIRECTOR/CHPS) |
| Authorized Official Telephone | 4349473656 |
| Is Organization Subpart | Y |
| Parent Organization Name | CENTRA HEALTH PROFESSIONAL SERVICES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Centra Health Breast Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043662828 | Centra Health Professional Services, LLC | Internal Medicine | 414 Park Avenue, Danville, VA 24541-9998 | 2016-07-06 |
| 1760776447 | Centra Health Professional Services, LLC | Family Medicine | 10961 Lee Jackson Highway, Big Island, VA 24526 | 2011-05-31 |
| 1811135593 | Centra Health Professional Services, LLC | Physical Medicine & Rehabilitation | 404 Airport Dr, Suite C, Danville, VA 24540-5196 | 2009-02-03 |
| 1346486560 | Centra Health Professional Services, LLC | Family Medicine | 1902 Grace St, Lynchburg, VA 24504-3524 | 2008-12-17 |
| 1497900047 | Centra Health Professional Services, LLC | Urology | 1039 Mayberry Crossing Drive, Moneta, VA 24121 | 2008-11-24 |
| 1538101969 | Centra Health Professional Services, LLC | Physical Medicine & Rehabilitation | 1900 Tate Springs Rd, Suite 16, Lynchburg, VA 24501-1122 | 2006-06-11 |
| 1235480351 | Centra Health Professional Services, LLC | Psychiatry & Neurology | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2012-09-28 |
| 1316298433 | Centra Health Professional Services, LLC | Psychiatry & Neurology | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2012-09-28 |
| 1033471438 | Centra Health Professional Services, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1701 Thomson Dr, Lynchburg, VA 24501-1118 | 2012-06-12 |
| 1770840654 | Centra Health Professional Services, LLC | Orthopaedic Surgery | 1613 Oakwood St, Suite 101, Bedford, VA 24523-1213 | 2012-04-18 |
| 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 | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306911664 | Centra Health, Inc. | Radiology | 20293 Timberlake Rd, Lynchburg, VA 24502-7202 | 2006-11-22 |
| 1144456609 | Lance Anthony Warren | Radiology | 113 Nationwide Dr, Lynchburg, VA 24502-4272 | 2009-06-10 |
| 1275726234 | Centra Health, Inc. | Radiology | 1901 Tate Springs Rd, Lynchburg, VA 24501-1109 | 2007-08-23 |
| 1295928174 | Matthew Blake Tomlin | Radiology | 113 Nationwide Dr, Lynchburg, VA 24502-4272 | 2007-08-23 |
| 1497955348 | Robert S Brindle | Radiology | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2007-07-19 |
| 1972725265 | Audrey E. Graham | Radiology | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2007-05-03 |
| 1386861821 | Centra Health Professional Services, LLC | Radiology | 3300 Rivermont Ave, Lynchburg, VA 24503-2030 | 2007-04-19 |
| 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 |
| 1376619254 | Centra Health Inc | Radiology | 1900 Tate Springs Rd, Lynchburg, VA 24501-1122 | 2006-11-24 |
| Find all providers in LYNCHBURG | ||||
Please comment or provide details below to improve the information on CENTRA HEALTH PROFESSIONAL SERVICES, LLC.
| 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.