Jacob Albert Wooten, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110008161 Issued in VA

Practice address

162 Mallard LN
Lynchburg, VA 24502-1154

Phone

(434) 420-1816

NPI assigned

Jun 28, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021

Merit-based Incentive Payment System (MIPS)

Final score

93.16 of 100Reported as apm

Quality

83.58

Promoting interoperability

94

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Centra Medical Group, LLC

  • Family Medicine Physician
  • Lynchburg, VA
  • NPI 1649228966
  Medicare reassignment Care Compare group NPD
• Centra Health Professional Services,LLC

  • Neurological Surgery Physician
  • Lynchburg, VA
  • NPI 1730483488
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Centra Health Inc

  • General Acute Care Hospital
  • Lynchburg, VA
  • NPI 1770693939
  Care Compare affiliation
• Centra Health Professional Services, LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lynchburg, VA
  • NPI 1407884448

  Hospital

  Care Compare affiliation
• Centra Health Professional Services, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Lynchburg, VA
  • NPI 1811925852

  Hospital

  Care Compare affiliation
• Centra Health Professional Services, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Lynchburg, VA
  • NPI 1902834948

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  • Vascular Surgery Physician
  • Lynchburg, VA
  • NPI 1144880782

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lynchburg, VA
  • NPI 1184964124

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  • Hematology & Oncology Physician
  • Lynchburg, VA
  • NPI 1700293628

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1629648209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 MALLARD LN",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245021154",
            "telephone_number": "434-420-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 MALLARD LN",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245021154",
            "telephone_number": "434-420-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "JACOB",
        "middle_name": "ALBERT",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Rakes Woody, LPC
• Wooldridge Heating & Air, Inc.
• Wooldridge Heating & Air, Inc.
• Samuel Edward Woolwine III, DDS
• Megan Woosley, NP-C
• Connor Shane Worley
• Katherine Worsham, LPC
• Teresa Irby Worsham
• Reed Worthington
• Michael Worthy

• Physician Assistant in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.