Centra Medical Group Bedford, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CENTRA MEDICAL GROUP BEDFORD, LLC

Practice address

1613 Oakwood St
Bedford, VA 24523-1213

Phone

(434) 200-3656

NPI assigned

Apr 15, 2014

Last updated

Apr 15, 2014By the provider in NPPES

Organization subpart

No

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) 200-5047

Specialties & licenses 8

Addresses

Practitioners 2

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.

• Joshua Wilson, PA

  • Physician Assistant
  • Indian Trail, NC
  • NPI 1770713133
  NPD
• Sara Eskridge, PA

  • Physician Assistant
  • Lynchburg, VA
  • NPI 1972585768
  NPD (past)

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1699194977",
    "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": "1613 OAKWOOD ST",
            "city": "BEDFORD",
            "state": "VA",
            "postal_code": "245231213",
            "telephone_number": "434-200-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRA MEDICAL GROUP BEDFORD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "ADDISON",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_title_or_position": "SR VP CFO",
        "authorized_official_telephone_number": "434-200-5047"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Bedford, VA
• Providers in Bedford, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.