Jacqueline Renee Perdue, PA-C
Individual provider Active NPI Physician Assistant · Moneta, VA
NPI 1013490655 · NPPES record last updated Sep 10, 2018
Key facts
- NPI
- 1013490655
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0110-006377 (VA)
- Practice address
- 4830 Rucker Rd
Moneta, VA 24121-5281 - Phone
- (540) 297-7181
- NPI assigned
- Sep 10, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Centra Medical Group LLC
Practice addresses (Care Compare)
1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033
2410 Atherholt Rd
Lynchburg, VA 24501-2148
Phone (434) 200-1800
291 McBride LN
Gretna, VA 24557-2773
Phone (434) 656-1274
Hospital & facility affiliations
- Centra Health - Lynchburg Gen Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.16 of 100
- Quality
- 83.58
- Promoting interoperability
- 94
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181116001383 | VA | Practitioner - Physician Assistant | 7214281856 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110-006377 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centra Medical Group, LLC | Current |
Accepting new patients | |
| Centra Medical Group, LLC | Current |
Accepting new patients |
Locations
1613 Oakwood St
Bedford, VA 24523
Phone (540) 425-7800
800 5th St
Lynchburg, VA 24504
Phone (434) 200-3366
1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101
1937 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-6965
4830 Rucker Rd
Moneta, VA 24121
Phone (540) 297-7181
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110-006377 | VA | Yes |
Addresses
Primary practice location
4830 Rucker Rd
Moneta, VA 24121-5281
Mailing address
1293 Red Fox LN
Moneta, VA 24121-2963
Phone (804) 720-4852
Other providers in Moneta, VA
- Marcia Dinkle Mason
- Lisa Williamson McArdle
- Next Step @ Work LLC
- Lora Nissen
- Donna Michelle O'Connell
- Tiffany Ann Powell
- Christopher Eugene Randolph
- Sherry Ann Ray
- Regal Medical Services, LTD
- Rodyhill Healthcare Solutions, LTD.
All providers in Moneta, VA · Physician Assistant in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.