Individual provider Active NPI

Luther L. Wright Jr., M.D.,M.SC.,MT(ASCP)

  • Internal Medicine Physician
  • Colonial Heights, VA
National Provider Identifier
1285705228
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101241279 Issued in VA
Practice address
524 Southpark Boulevard
Jencare Neighborhood Medical South Park, LLC
Colonial Heights, VA 23834
Phone
(804) 504-7980
Fax
(804) 504-7991
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101241279 VA Primary

Addresses

Primary practice location

524 Southpark Boulevard
Jencare Neighborhood Medical South Park, LLC
Colonial Heights, VA 23834

Mailing address

524 Southpark Boulevard
Jencare Neighborhood Medical South Park, LLC
Colonial Heights, VA 23834
Phone (804) 504-7980

Other identifiers 2

IdentifierTypeStateIssuer
1285705228MedicaidVA
293417OtherVABCBS

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
I20070503000659 VA Practitioner - Internal Medicine 5294831467 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Virginia Holding, LLC CurrentSince Apr 1, 2021 Accepting new patients
Jencare Neighborhood Medical New Market, LLC Internal Medicine CurrentSince Jun 20, 2018 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

524 Southpark Blvd
Colonial Hgts, VA 23834
Phone (804) 504-7980

48 Newmarket Sq
Newport News, VA 23605
Phone (757) 825-8030

3806 Mechanicsville Tpke
Richmond, VA 23223
Phone (804) 228-1143

5516 Virginia Beach Blvd
Virginia Beach, VA 23462
Phone (757) 287-3699

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1285705228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 SOUTHPARK BOULEVARD",
            "address_2": "JENCARE NEIGHBORHOOD MEDICAL SOUTH PARK, LLC",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "23834",
            "telephone_number": "804-504-7980",
            "fax_number": "804-504-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 SOUTHPARK BOULEVARD",
            "address_2": "JENCARE NEIGHBORHOOD MEDICAL SOUTH PARK, LLC",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "23834",
            "telephone_number": "804-504-7980",
            "fax_number": "804-504-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "LUTHER",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.,M.SC.,MT(ASCP)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101241279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285705228",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "293417",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

Verify at the official NPI Registry.