NPIMap

Organization Active NPI

Centra Medical Group, LLC

Doing business as CMG Gretna Pulmonology Center

  • Pulmonary Disease Physician
  • Gretna, VA
National Provider Identifier
1689268765
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
CENTRA MEDICAL GROUP, LLC
Doing business as
CMG Gretna Pulmonology Center
Practice address
291 McBride LN
Gretna, VA 24557-2773
Phone
(434) 200-4030
Fax
(434) 200-1657
NPI assigned
Mar 1, 2021
Last updated
Mar 1, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRA MEDICAL GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Authorized official

Name
Sonya R T Davis
Title
Director, Revenue Cycle
Phone
(434) 200-6942

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X NU Primary

Addresses

Primary practice location

291 McBride LN
Gretna, VA 24557-2773

Mailing address

291 McBride LN
Gretna, VA 24557-2773
Phone (434) 200-4030

Other names 1

  • CMG Gretna Pulmonology Center 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": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1689268765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 MCBRIDE LN",
            "city": "GRETNA",
            "state": "VA",
            "postal_code": "245572773",
            "telephone_number": "434-200-4030",
            "fax_number": "434-200-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 MCBRIDE LN",
            "city": "GRETNA",
            "state": "VA",
            "postal_code": "245572773",
            "telephone_number": "434-200-4030",
            "fax_number": "434-200-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRA MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRA MEDICAL GROUP, LLC",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SONYA",
        "authorized_official_middle_name": "R T",
        "authorized_official_title_or_position": "DIRECTOR, REVENUE CYCLE",
        "authorized_official_telephone_number": "434-200-6942"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMG Gretna Pulmonology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gretna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.