Individual provider Active NPI

Jenna Nicole Donelson, PA

  • Physician Assistant
  • Lynchburg, VA
National Provider Identifier
1396582151
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110010403 Issued in VA
Practice address
1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone
(434) 200-3027
NPI assigned
Jul 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110010403 VA Primary

Addresses

Primary practice location

1901 Tate Springs Rd
Lynchburg, VA 24501-1109

Mailing address

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (609) 707-7731

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241109000036 VA Practitioner - Physician Assistant 7810421146 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110010403VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Health Professional Services, LLC CurrentSince Oct 28, 2024 Accepting new patients
Centra Medical Group, LLC CurrentSince Oct 28, 2024 Accepting new patients

Locations

140 Vista Centre Dr
Fl 2
Forest, VA 24551
Phone (434) 200-2297

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

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": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1396582151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 TATE SPRINGS RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011109",
            "telephone_number": "609-707-7731"
        },
        {
            "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": "434-200-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONELSON",
        "first_name": "JENNA",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.