Individual provider Active NPI

Nnamdi Charles Iwuala, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Lynchburg, VA
National Provider Identifier
1467086819
Registry record updated Jun 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
0101282002 Issued in VA
Practice address
1330 Oak LN
Lynchburg, VA 24503-2513
Phone
(434) 200-5757
Fax
(434) 200-1128
NPI assigned
Feb 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 0101282002 VA Primary

Addresses

Primary practice location

1330 Oak LN
Lynchburg, VA 24503-2513

Mailing address

1330 Oak LN
Lynchburg, VA 24503-2513
Phone (434) 200-5757

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
I20240828002080 VA Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 5991244469

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

140 Vista Centre Dr
FL 2
Forest, VA 24551-3965

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

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

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

1330 Oak Ln
Ste 202
Lynchburg, VA 24503
Phone (344) 200-5757

Organizations & group practices 1

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": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719100800000",
    "number": "1467086819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 OAK LN",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245032513",
            "telephone_number": "434-200-5757",
            "fax_number": "434-200-1128"
        },
        {
            "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": "434-200-5757",
            "fax_number": "434-200-1128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWUALA",
        "first_name": "NNAMDI",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-25",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "VA",
            "license": "0101282002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.