NPIMap

Organization Active NPI

Central Virginia Health Services Inc

Doing business as CVHS Charlottesville

  • Federally Qualified Health Center (FQHC)
  • Charlottesville, VA
National Provider Identifier
1548632508
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTRAL VIRGINIA HEALTH SERVICES INC
Doing business as
CVHS Charlottesville
Practice address
1101 E Jefferson St Ste 1
Charlottesville, VA 22902-5353
Phone
(434) 227-5624
Fax
(434) 970-7700
NPI assigned
Oct 29, 2015
Last updated
Oct 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Authorized official

Name
Charles Allbaugh
Title
Cfo
Phone
(434) 581-4073

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X VA Primary

Addresses

Primary practice location

1101 E Jefferson St Ste 1
Charlottesville, VA 22902-5353

Mailing address

PO Box 220
New Canton, VA 23123-0220
Phone (434) 581-3271

Other names 1

  • CVHS Charlottesville Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151218001842 VA Part A Provider - Federally Qualified Health Center (FQHC) 0345158432 Practice locations: Charlottesville, VA
O20160524000221 VA Part B Supplier - Clinic/Group Practice 0345158432 Receives reassigned benefits from 26 practitioners
Practice locations: Charlottesville, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548632508. Details of each certification follow.

Federally qualified health center certification: CCN 491943

Legal name
CENTRAL VIRGINIA HEALTH SERVICES INC
Doing business as
CVHS CHARLOTTESVILLE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 10, 2015
Last certification
Dec 10, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 15, 1970 in VA
Enrollment address
1101 E Jefferson St
Ste 1
Charlottesville, VA 22902-5353

Other NPIs with the same Medicare PAC ID 18

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 18

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2105031CVHS Charlottesville1101 E Jefferson Street Suite 1, Charlottesville, VA 22902Provider-performed microscopyNov 16, 2027

National Provider Directory

National Provider Directory

Locations

901 Preston Ave
Ste 301
Charlottesville, VA 22903
Phone (434) 227-5624

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tamica Williams Individual Corporate DirectorBoard Member Dec 1, 2014
Samuel Bateman Individual Corporate DirectorBoard Secretary Mar 21, 2003
Randall Thomas Bashore Individual W-2 Managing EmployeeMedical Director Jul 8, 1985
Rosario-Ninel E Foss Individual Corporate DirectorBoard Member Nov 1, 2016
Aracely Harris Individual Corporate DirectorBoard Member Feb 1, 2020
Evelyn Benet Individual Corporate DirectorBoard Member Oct 1, 2014
Marguerite Young Individual Corporate DirectorBoard Member Jan 1, 2009
Paula Tomko Individual Corporate OfficerCeo Jan 1, 2020
Corporate DirectorCeo Jan 1, 2020
W-2 Managing EmployeeCeo Jan 1, 2020
Byron Adkins Individual Corporate DirectorBoard Member Mar 21, 2003
Carolyn Perry Individual Corporate DirectorBoard Member Dec 1, 2014
Debra Jones Individual Corporate DirectorBoard Member Dec 1, 2014
Peggy Scott Individual Corporate DirectorBoard Member Feb 1, 1996
Charles Allbaugh Individual W-2 Managing EmployeeCfo Sep 18, 1995
Jearline Taylor Individual Corporate DirectorBoard Member Jan 1, 2000
Frankie Sheridan Individual Corporate DirectorBoard President Mar 21, 2003
Robert C Smith Individual Corporate DirectorBoard Member Dec 1, 2007

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
CVHS PetersonCharlottesville, VA, CCN 491958 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1548632508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "NEW CANTON",
            "state": "VA",
            "postal_code": "231230220",
            "telephone_number": "434-581-3271",
            "fax_number": "414-581-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E JEFFERSON ST STE 1",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025353",
            "telephone_number": "434-227-5624",
            "fax_number": "434-970-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL VIRGINIA HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "ALLBAUGH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "434-581-4073"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVHS Charlottesville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.