NPIMap

Individual provider Active NPI

Lyn Rose Calderoni

  • Acute Care Nurse Practitioner
  • Lynchburg, VA
National Provider Identifier
1073091112
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0024176417 Issued in VA
Practice address
1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone
(434) 200-3000
NPI assigned
Jul 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0024176417 VA Primary

Addresses

Primary practice location

1901 Tate Springs Rd
Lynchburg, VA 24501-1109

Mailing address

1091 Ickleton PL
Forest, VA 24551-2744
Phone (434) 851-0069

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
I20181115002812 VA Practitioner - Nurse Practitioner 1759635469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024176417VAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Apr 1, 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

Organizations & group practices 2

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 9

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": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1073091112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 ICKLETON PL",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512744",
            "telephone_number": "434-851-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 TATE SPRINGS RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011109",
            "telephone_number": "434-200-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERONI",
        "first_name": "LYN",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024176417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.