NPIMap

Organization Active NPI

Centra Medical Group, LLC

Doing business as Centra TelePsych Services

  • Psychiatry Physician
  • Lynchburg, VA
National Provider Identifier
1629466016
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CENTRA MEDICAL GROUP, LLC
Doing business as
Centra TelePsych Services
Practice address
3300 Rivermont Ave
Lynchburg, VA 24503-2030
Phone
(434) 200-5999
NPI assigned
Jan 7, 2015
Last updated
Jan 7, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRA MEDICAL GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Authorized official

Name
Lewis Addison
Title
Sr VP Cfo
Phone
(434) 200-3656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

3300 Rivermont Ave
Lynchburg, VA 24503-2030

Mailing address

2010 Atherholt Rd
Lynchburg, VA 24501-1106

Other names 1

  • Centra TelePsych Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Centra Health Professional Services106 organizations share this tax ID, including this one
Part of
Centra Health Professional Services

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1629466016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 RIVERMONT AVE",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245032030",
            "telephone_number": "434-200-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRA MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRA MEDICAL GROUP, LLC",
        "enumeration_date": "2015-01-07",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "ADDISON",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_title_or_position": "SR VP CFO",
        "authorized_official_telephone_number": "434-200-3656"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centra TelePsych Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynchburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.