NPIMap

Centra Health Professional Services, LLC

Organization Active NPI Pain Medicine (Anesthesiology) Physician · Lynchburg, VA

NPI 1811925852 · NPPES record last updated Mar 4, 2008

Key facts

NPI
1811925852
Entity type
Organization (NPI type 2)
Primary specialty
Pain Medicine (Anesthesiology) Physician 207LP2900X
Legal business name
CENTRA HEALTH PROFESSIONAL SERVICES, LLC
Practice address
3300 Rivermont Ave
Lynchburg, VA 24503-2030
Phone
(434) 947-4175
NPI assigned
Jun 29, 2006
Organization subpart
Yes
Parent organization (as reported)
CENTRA HEALTH PROFESSIONAL SERVICES, LLC

Authorized official

Name
Tammy Tweedy
Title
Director
Phone
(434) 947-5047

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1,123

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,123

Medicare Care Compare: Hospital

Listed as
Centra Health - Lynchburg Gen Hospital CCN 490021
Overall star rating
★★★☆☆ 3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in VA

Hospital certification: CCN 490021

Legal name
CENTRA HEALTH, INC
Doing business as
VA BAPTIST LYNCHBURG GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 20, 2010
Beds
519
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Enrollment address
3300 Rivermont Ave
Lynchburg, VA 24503-2030
Other Hospital Practice Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John Fees
Individual 		Corporate Director
Board Member		 Jan 1, 2023
Robert Tonkinson
Individual 		Corporate Officer
Cfo		 Jan 1, 2025
Gloria Witt
Individual 		Corporate Director
Board Member		 Jan 1, 2023
Pamela S Bradford
Individual 		Corporate Director Jan 1, 2025
Todd Irby
Individual 		Corporate Director Jan 1, 2018
Peter a Caprise
Individual 		Corporate Director Oct 19, 2018
Cynthia D Gunnoe
Individual 		Corporate Director
Board Member		 Jan 1, 2023
Gary Mignogna
Individual 		Corporate Director Jan 1, 2022
Kemper Beasley
Individual 		Corporate Director Jan 1, 2022
Richard J Tugman
Individual 		Corporate Officer
Ceo		 Jan 1, 2025
Bonnie Svrcek
Individual 		Corporate Director Jan 1, 2022
Clinton S Beverly
Individual 		Corporate Director Jan 1, 2022
Cameron Patterson
Individual 		Corporate Director Jan 1, 2025
Amy Gallagher
Individual 		Corporate Director Jan 1, 2024
Thomas Nygaard
Individual 		Corporate Officer Jan 1, 2022
Geeta Rakheram
Individual 		Corporate Director Jan 1, 2022
Timothy Fritz
Individual 		W-2 Managing Employee Apr 30, 2019
Rosana Chaidez
Individual 		Corporate Director Jan 1, 2026

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20051230000147 VA Part B Supplier - Clinic/Group Practice 4789606088 Receives reassigned benefits from 865 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20160224000056 VA Part a Provider - Hospital 6002719713 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lynchburg, VA

National Provider Directory

Tax ID family
Centra Health Professional Services (106 organizations share this tax ID)
Part of
Centra Health Professional Services

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207LP2900X Yes

Addresses

Primary practice location

3300 Rivermont Ave
Lynchburg, VA 24503-2030

Mailing address

1204 Fenwick Dr
Lynchburg, VA 24502-2112

Other names

  • The Pain Center Doing business as

Other providers in Lynchburg, VA

All providers in Lynchburg, VA · Pain Medicine (Anesthesiology) Physician in Virginia

Sources for this page

Verify at the official NPI Registry.