Central Virginia Health Services Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Charlottesville, VA
NPI 1548632508 · NPPES record last updated Oct 28, 2020
Key facts
- NPI
- 1548632508
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- CENTRAL VIRGINIA HEALTH SERVICES INC
- 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
- Organization subpart
- No
Authorized official
- Name
- Charles Allbaugh
- Title
- Cfo
- Phone
- (434) 581-4073
Owners & managing parties with NPI records 1
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 18
Practitioners 105
-
Stephanie Karen Brownell, APRN, AGPCNP-BC
-
Janet Carol Chenault, MSN, APRN, FNP-C
-
Elizabeth Hirner, LCSW
-
Daezel Aler Lacanlale, FNP-C
-
Mary B. Preston, M.D.
-
Amy Michelle Randolph, DNP, FNP-C
-
Carolyn Saunders, WHCNP
-
Dana Lindgren Shoup, N.P.
-
Melissa South, L.C.S.W.
-
David C Streicher, PHD
-
Sarah Trimble, LCSW
-
Annetta Williams, LCSW
-
Kate E. Becker, C.N.M.
-
Erika Gazzetta, MD
-
Julia Foster Hill, DNP
-
Morgan Honickel, LCSW
-
Kujore McKinney, APRN
-
Shelia Kaye Talbott, FNP
-
Jamie Pettus, PSYD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D2105031 | CVHS Charlottesville | Provider-performed microscopy | Nov 16, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA
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
- Corporation · Non-profit
- Incorporated
- Jun 15, 1970 in VA
- Enrollment address
- 1101 E Jefferson St
Ste 1
Charlottesville, VA 22902-5353
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Tamica Williams |
Corporate Director |
Dec 1, 2014 | |
| Samuel Bateman |
Corporate Director |
Mar 21, 2003 | |
| Randall Thomas Bashore |
W-2 Managing Employee |
Jul 8, 1985 | |
| Rosario-Ninel E Foss |
Corporate Director |
Nov 1, 2016 | |
| Aracely Harris |
Corporate Director |
Feb 1, 2020 | |
| Evelyn Benet |
Corporate Director |
Oct 1, 2014 | |
| Marguerite Young |
Corporate Director |
Jan 1, 2009 | |
| Paula Tomko |
Corporate Officer |
Jan 1, 2020 | |
| Corporate Director |
Jan 1, 2020 | ||
| W-2 Managing Employee |
Jan 1, 2020 | ||
| Byron Adkins |
Corporate Director |
Mar 21, 2003 | |
| Carolyn Perry |
Corporate Director |
Dec 1, 2014 | |
| Debra Jones |
Corporate Director |
Dec 1, 2014 | |
| Peggy Scott |
Corporate Director |
Feb 1, 1996 | |
| Charles Allbaugh |
W-2 Managing Employee |
Sep 18, 1995 | |
| Jearline Taylor |
Corporate Director |
Jan 1, 2000 | |
| Frankie Sheridan |
Corporate Director |
Mar 21, 2003 | |
| Robert C Smith |
Corporate Director |
Dec 1, 2007 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| CVHS Peterson |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Dec 1, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Locations
901 Preston Ave
Ste 301
Charlottesville, VA 22903
Phone (434) 227-5624
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | VA | Yes |
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
- CVHS Charlottesville
Other providers in Charlottesville, VA
- Ivonne Cedillos
- Center for Integrated Recovery, LLC
- Center for Mind and Body Health
- Center for Wellness & Change, LLC
- Central Virginia Health Service Inc
- Central Virginia Holdings, Inc.
- Central Virginia Oral & Facial Surgeons, PLC
- Central Virginia Psycholgical Services
- Central Virginia Radiation Oncologists P C
- Central Virginia Senior Care, LLC
All providers in Charlottesville, VA · Federally Qualified Health Center (FQHC) in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.