NPIMap

Individual provider Active NPI

Colin Malcolm

  • Physician Assistant
  • Lynchburg, VA
National Provider Identifier
1003486663
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110008132 Issued in VA
Practice address
125 Nationwide Dr
Lynchburg, VA 24502-4272
Phone
(434) 200-3908
NPI assigned
Jun 28, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110008132 VA Primary

Addresses

Primary practice location

125 Nationwide Dr
Lynchburg, VA 24502-4272

Mailing address

125 Nationwide Dr
Lynchburg, VA 24502-4272
Phone (434) 200-3908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220214001328 VA Practitioner - Physician Assistant 9335532415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

125 Nationwide Dr
Lynchburg, VA 24502-4272
Phone (434) 200-3908

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Roanoke, VA, CCN 497275
  • Centra Home Health Home health agency, Lynchburg, VA, CCN 497278
  • Enhabit Home Health (Lynchburg) Home health agency, Forest, VA, CCN 497533
  • Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110008132VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Jan 28, 2022 Accepting new patients
Centra Medical Group, LLC CurrentSince Jan 28, 2022 Accepting new patients

Locations

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

125 Nationwide Dr
Lynchburg, VA 24502
Phone (434) 200-3908

1937 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-6965

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1003486663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 NATIONWIDE DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245024272",
            "telephone_number": "434-200-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 NATIONWIDE DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245024272",
            "telephone_number": "434-200-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCOLM",
        "first_name": "COLIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.