NPIMap

Organization Active NPI

Centra Medical Group, LLC

Doing business as Centra Medical Group Bedford Medical

  • Family Medicine Physician
  • Bedford, VA
National Provider Identifier
1184045254
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CENTRA MEDICAL GROUP, LLC
Doing business as
Centra Medical Group Bedford Medical
Practice address
171 W Main St
Bedford, VA 24523-1950
Phone
(540) 586-7273
NPI assigned
Dec 17, 2013
Last updated
Jan 30, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRA MEDICAL GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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) 200-5047

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

171 W Main St
Bedford, VA 24523-1950

Mailing address

2010 Atherholt Rd
Lynchburg, VA 24501-1106

Other names 1

  • Centra Medical Group Bedford Medical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Centra Health Professional Services106 organizations share this tax ID, including this one
Part of
Centra Health Professional Services

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391040000000",
    "number": "1184045254",
    "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": "245011106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 W MAIN ST",
            "city": "BEDFORD",
            "state": "VA",
            "postal_code": "245231950",
            "telephone_number": "540-586-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRA MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRA MEDICAL GROUP, LLC",
        "enumeration_date": "2013-12-17",
        "last_updated": "2014-01-30",
        "status": "A",
        "authorized_official_last_name": "ADDISON",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_title_or_position": "SR VP, CFO",
        "authorized_official_telephone_number": "434-200-5047"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centra Medical Group Bedford Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bedford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.