NPIMap

Organization Active NPI

Central Virginia Family Psychiatry PC

  • Cognitive & Behavioral Psychologist
  • Petersburg, VA
National Provider Identifier
1477512416
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
Legal business name
CENTRAL VIRGINIA FAMILY PSYCHIATRY PC
Practice address
43 Rives Rd
Suite B
Petersburg, VA 23805-9255
Phone
(804) 732-1527
Fax
(804) 732-8210
NPI assigned
Mar 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Authorized official

Name
James W Wooldridge Jr., MD
Title
President
Phone
(804) 732-1527

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X Primary

Addresses

Primary practice location

43 Rives Rd
Suite B
Petersburg, VA 23805-9255

Mailing address

PO Box 11786
Richmond, VA 23230-0186
Phone (804) 672-4836

Other identifiers 1

IdentifierTypeStateIssuer
C08729OtherGROUP MEDICARE NUMBER

National Provider Directory

National Provider Directory

Locations

510 S Sycamore St
#G
Petersburg, VA 23803
Phone (804) 861-0700

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268870400000",
    "number": "1477512416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11786",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232300186",
            "telephone_number": "804-672-4836",
            "fax_number": "804-213-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 RIVES RD",
            "address_2": "SUITE B",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059255",
            "telephone_number": "804-732-1527",
            "fax_number": "804-732-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL VIRGINIA FAMILY PSYCHIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2010-03-18",
        "status": "A",
        "authorized_official_last_name": "WOOLDRIDGE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-732-1527",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE NUMBER",
            "identifier": "C08729",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.