NPIMap

Individual provider Active NPI

Cecilia Maribee Maccallum, M.D.

  • Specialist
  • Lynchburg, VA
National Provider Identifier
1114951852
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101239992 Issued in VA
Practice address
1701 Thomson Dr
Suite 200
Lynchburg, VA 24501-1118
Phone
(434) 200-5925
Fax
(434) 200-5929
NPI assigned
Jul 10, 2006
Last updated
Oct 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101239992 VA Primary

Addresses

Primary practice location

1701 Thomson Dr
Suite 200
Lynchburg, VA 24501-1118

Mailing address

2010 Atherholt Rd
Lynchburg, VA 24501
Phone (434) 200-5047

Other identifiers 2

IdentifierTypeStateIssuer
010294941MedicaidVA
0101239992OtherVAMEDICAL LICENSE NUMBER

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
I20061020000140 VA Practitioner - HematologyPractitioner - Internal MedicinePractitioner - Medical Oncology 9335145093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HematologyAlso: Internal Medicine
Education
George Washington University School of Medicine, 1999
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

Practice addresses (Care Compare)

1701 Thomson Dr
Lynchburg, VA 24501-1118
Phone (434) 200-4522

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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Sep 1, 2014 Accepting new patients
Centra Medical Group, LLC Past Accepting new patients

Locations

140 Vista Centre Dr
Fl 2
Forest, VA 24551
Phone (434) 200-2297

1701 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-4010

1701 Thomson Dr
#200
Lynchburg, VA 24501
Phone (434) 200-5925

1701 Thomson Dr
Ste 200
Lynchburg, VA 24501
Phone (434) 200-5925

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

2010 Atherholt Rd
Lynchburg, VA 24501
Phone (434) 200-3656

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1114951852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "24501",
            "telephone_number": "434-200-5047",
            "fax_number": "434-200-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 THOMSON DR",
            "address_2": "SUITE 200",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011118",
            "telephone_number": "434-200-5925",
            "fax_number": "434-200-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCALLUM",
        "first_name": "CECILIA",
        "middle_name": "MARIBEE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101239992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010294941",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "0101239992",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.