Individual provider Active NPI

Cynthia Lynn Pender, LCSW

  • Clinical Social Worker
  • Fishersville, VA
National Provider Identifier
1265279632
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904013349 Issued in VA
Practice address
79 N Medical Park Dr
Fishersville, VA 22939-2344
Phone
(540) 213-2525
Fax
(540) 213-2555
NPI assigned
Jul 11, 2024
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904013349 VA Primary

Addresses

Primary practice location

79 N Medical Park Dr
Fishersville, VA 22939-2344

Mailing address

PO Box 388
Fishersville, VA 22939-0388
Phone (540) 213-2525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241003000149 VA Practitioner - Clinical Social Worker 9335670264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Augusta Medical GroupGroup PAC ID 3678632544, 409 clinicians

Practice addresses (Care Compare)

79 N Medical Park Dr
Fishersville, VA 22939-2344
Phone (540) 213-2525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta Medical Group CurrentSince Jul 29, 2024 Accepting new patients
Augusta Medical Group CurrentSince Jul 29, 2024 Accepting new patients

Locations

53 S Medical Park Dr
Fishersville, VA 22939
Phone (540) 332-5687

79 N Medical Park Dr
Fishersville, VA 22939
Phone (540) 213-2525

Interoperability endpoints

  • Direct secure messaging: cynthia.pender.1@14718.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14718/brand/4/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1265279632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229390388",
            "telephone_number": "540-213-2525",
            "fax_number": "540-213-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 N MEDICAL PARK DR",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392344",
            "telephone_number": "540-213-2525",
            "fax_number": "540-213-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDER",
        "first_name": "CYNTHIA",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904013349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.