NPIMap

Individual provider Active NPI

Colleen Nakamura, PA

  • Physician Assistant
  • Lynchburg, VA
National Provider Identifier
1801827233
Registry record updated May 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001810 Issued in VA
Practice address
2137 Lakeside Dr
Lynchburg, VA 24501-6806
Phone
(434) 385-4184
Fax
(434) 385-8616
NPI assigned
Jul 5, 2006
Last updated
May 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110001810 VA Primary

Addresses

Primary practice location

2137 Lakeside Dr
Lynchburg, VA 24501-6806

Mailing address

PO Box 2489
#1
Forest, VA 24551-6489
Phone (434) 382-1139

Other identifiers 3

IdentifierTypeStateIssuer
C03658OtherMEDICARE GROUP PTAN
1528155892OtherCVFP CORPORATE NPI
1972680049OtherCVFP SITE NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050303000968 VA Practitioner - Physician Assistant 9133173016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

14005 Wards Rd
Suite a
Lynchburg, VA 24501-7127
Phone (434) 239-0132

2832 Candlers Mountain Rd
Lynchburg, VA 24502-2287
Phone (434) 239-3949

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Nov 29, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 29, 2016 Accepting new patients
Medical Associates of Central Virginia, Inc. Past Accepting new patients
Central Virginia Family Physicians, Inc. Laboratory Past Accepting new patients

Locations

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

2019 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 845-7035

2137 Lakeside Dr
Lynchburg, VA 24501
Phone (434) 385-4184

14005 Wards Rd
#A
Lynchburg, VA 24501
Phone (434) 239-0132

2832 Candlers Mountain Rd
Lynchburg, VA 24502
Phone (434) 239-3949

2019 Tate Springs Rd
Lowr
Lynchburg, VA 24501
Phone (434) 846-7708

8644 Sudley Rd
#220
Manassas, VA 20110

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1801827233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2489",
            "address_2": "#1",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245516489",
            "telephone_number": "434-382-1139",
            "fax_number": "434-525-5748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 LAKESIDE DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245016806",
            "telephone_number": "434-385-4184",
            "fax_number": "434-385-8616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA",
        "first_name": "COLLEEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "C03658",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CVFP CORPORATE NPI",
            "identifier": "1528155892",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CVFP SITE NPI",
            "identifier": "1972680049",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.