Individual provider Active NPI

Jennifer Tice, ACNP-BC

  • Acute Care Nurse Practitioner
  • Lynchburg, VA
National Provider Identifier
1801145461
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0024170283 Issued in VA
Practice address
2011 Tate Springs Rd
Lynchburg, VA 24501-1111
Phone
(434) 947-3963
NPI assigned
Aug 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0024170283 VA Primary

Addresses

Primary practice location

2011 Tate Springs Rd
Lynchburg, VA 24501-1111

Mailing address

2011 Tate Springs Rd
Lynchburg, VA 24501-1111

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20121004000004 VA Practitioner - Nurse Practitioner 6507015732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
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)

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033

Hospital & facility affiliations

  • Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021
  • Centra Bedford Memorial Hospital Hospital, Bedford, VA, CCN 490088

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024170283VAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince May 1, 2020 Accepting new patients
Centra Medical Group, LLC PastSince May 25, 2025 Accepting new patients

Locations

2512 Langhorne Rd
Lynchburg, VA 24501
Phone (434) 528-2194

2011 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 947-3963

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

2125 Langhorne Rd
Ste 504
Lynchburg, VA 24501
Phone (434) 528-2194

2125 Langhorne Rd
Ste 503
Lynchburg, VA 24501
Phone (434) 947-3963

1937 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-6965

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1801145461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 TATE SPRINGS RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 TATE SPRINGS RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011111",
            "telephone_number": "434-947-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICE",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024170283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.