Individual provider Active NPI

Jessica Ann Welsh, MD

  • Emergency Medicine Physician
  • Lynchburg, VA
National Provider Identifier
1346330339
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101265848 Issued in VA
Practice address
1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone
(434) 200-3000
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-122950 IL
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 0101265848 VA Primary

Addresses

Primary practice location

1901 Tate Springs Rd
Lynchburg, VA 24501-1109

Mailing address

2317 Rivermont Ave
Lynchburg, VA 24503-1523
Phone (815) 228-9256

Other practice location 1

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-6710

Other names 1

  • Jessica Ann Gedraitis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090701000351 IL Practitioner - Emergency Medicine 4880745983 Reassigns benefits to 3 organizations
I20191003001340 VA Practitioner - Emergency Medicine 4880745983 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-122950ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center CurrentSince Jul 23, 2009 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Osf Healthcare System Current Accepting new patients
Centra Health Professional Services, LLC CurrentSince Sep 16, 2019 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Centra Medical Group, LLC CurrentSince Sep 16, 2019 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

5111 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 683-5700

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

5114 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 655-2431

530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393

2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828

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

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

Organizations & group practices 7

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1346330339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 RIVERMONT AVE",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245031523",
            "telephone_number": "815-228-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 TATE SPRINGS RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011109",
            "telephone_number": "434-200-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "309-655-6710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELSH",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-122950",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101265848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GEDRAITIS",
            "middle_name": "ANN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.