Centra Medical Group, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

CENTRA MEDICAL GROUP, LLC

Doing business as

Altavista Medical Center RHC

Practice address

1280A Main St
Altavista, VA 24517-1465

Phone

(434) 309-1165

NPI assigned

Mar 2, 2011

Last updated

Nov 14, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

CENTRA MEDICAL GROUP, LLCAs reported in NPPES

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

Authorized official

Name

Lewis Addison

Title

Sr VP, Cfo

Phone

(434) 200-3656

Specialties & licenses 1

Addresses

Other names 1

• Altavista Medical Center RHC Doing business as

Part of

Centra Health Professional Services

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352851200000",
    "number": "1164720058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 FENWICK DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245022112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280A MAIN ST",
            "city": "ALTAVISTA",
            "state": "VA",
            "postal_code": "245171465",
            "telephone_number": "434-309-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRA MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRA MEDICAL GROUP, LLC",
        "enumeration_date": "2011-03-02",
        "last_updated": "2012-11-14",
        "status": "A",
        "authorized_official_last_name": "ADDISON",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_title_or_position": "SR VP, CFO",
        "authorized_official_telephone_number": "434-200-3656"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Altavista Medical Center RHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brenda M Elliott DDS PLC (Brenda M. Elliott, DDS)
• Emily Carroll
• Francis C. Carter, M.D.
• Britney Cawley
• Centra Health Professional Services, LLC (Altavista Medical Center)
• Connect 2 Transportation Services, LLC
• Chad Michael Conner, PHARM.D.
• Jeffery Dalton, RPH
• James David Danner, D.O.
• Brandi Davis

• Rural Health Clinic/Center in Altavista, VA
• Providers in Altavista, VA by specialty
• Rural Health Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.