Individual provider Active NPI

Judith A. Perrotto, M.D.

  • Diagnostic Radiology Physician
  • Lynchburg, VA
National Provider Identifier
1265572945
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101055222 Issued in VA
Practice address
1330 Oak LN
Lynchburg, VA 24503-2513
Phone
(434) 200-4072
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101055222 VA Primary

Addresses

Primary practice location

1330 Oak LN
Lynchburg, VA 24503-2513

Mailing address

1204 Fenwick Dr
Lynchburg, VA 24502-2112
Phone (434) 200-3656

Other identifiers 1

IdentifierTypeStateIssuer
1265572945MedicaidVA

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040421001646 VA Practitioner - Diagnostic Radiology 4284620683 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101055222VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Jul 1, 2007 Accepting new patients

Locations

1330 Oak Ln
Lynchburg, VA 24503
Phone (434) 200-4072

3300 Rivermont Ave
Lynchburg, VA 24503
Phone (434) 200-4668

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

1204 Fenwick Dr
Lynchburg, VA 24502
Phone (434) 200-3656

1937 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-6965

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.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1265572945",
    "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",
            "telephone_number": "434-200-3656",
            "fax_number": "434-200-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 OAK LN",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245032513",
            "telephone_number": "434-200-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERROTTO",
        "first_name": "JUDITH",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101055222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265572945",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.