NPIMap

Individual provider Active NPI

Blakley Walker Sproles, PA-C

  • Physician Assistant
  • Lynchburg, VA
National Provider Identifier
1831747955
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-007454 Issued in VA
Practice address
2410 Atherholt Rd
Lynchburg, VA 24501-2148
Phone
(434) 200-1800
NPI assigned
Sep 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17104 TX
Physician Assistant 363A00000X 0110-007454 VA Primary

Addresses

Primary practice location

2410 Atherholt Rd
Lynchburg, VA 24501-2148

Mailing address

3500 S Great Southwest Pkwy Apt 307
Grand Prairie, TX 75052-7385
Phone (276) 791-0837

Other practice location 1

7230 Crawford Rd
Argyle, TX 76226-2677
Phone (682) 683-2301

Other practice location 2

3101 Churchill Dr Ste 100
Flower Mound, TX 75022-2717
Phone (682) 683-2301

Other practice location 3

1720 Fm 544 Ste 100
Lewisville, TX 75056-4592
Phone (682) 683-2301

Other practice location 4

4545 Heritage Trace Pkwy Ste 1500
Fort Worth, TX 76244-8938
Phone (682) 683-2301

Other practice location 5

9990 Dallas Pkwy Ste 125
Frisco, TX 75033-4137
Phone (682) 683-2301

Other practice location 6

4150 N Collins St
Arlington, TX 76005-4547
Phone (682) 683-2301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201016001911 VA Practitioner - Physician Assistant 7517387343 Reassigns benefits to 1 organization
I20231018002369 TX Practitioner - Physician Assistant 7517387343 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

3300 Rivermont Ave
Lynchburg, VA 24503-2030
Phone (434) 200-5999

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Roanoke, VA, CCN 497275
  • Centra Home Health Home health agency, Lynchburg, VA, CCN 497278
  • Enhabit Home Health (Lynchburg) Home health agency, Forest, VA, CCN 497533
  • Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021
  • Centra Specialty Hospital Long-term care hospital, Lynchburg, VA, CCN 492010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110-007454VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Health Professional Services,LLC CurrentSince Jan 6, 2025 Accepting new patients
Centra Medical Group, LLC CurrentSince Jan 6, 2025 Accepting new patients

Locations

140 Vista Centre Dr
Fl 2
Forest, VA 24551
Phone (434) 200-2297

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

2410 Atherholt Rd
Lynchburg, VA 24501
Phone (434) 200-5252

800 5th St
Lynchburg, VA 24504
Phone (434) 200-3366

Organizations & group practices 5

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 11

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": "1567382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1831747955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 S GREAT SOUTHWEST PKWY APT 307",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750527385",
            "telephone_number": "276-791-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012148",
            "telephone_number": "434-200-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7230 Crawford Rd",
            "address_purpose": "LOCATION",
            "city": "Argyle",
            "state": "TX",
            "postal_code": "762262677",
            "country_code": "US",
            "telephone_number": "682-683-2301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3101 Churchill Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Flower Mound",
            "state": "TX",
            "postal_code": "750222717",
            "country_code": "US",
            "telephone_number": "682-683-2301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1720 Fm 544 Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lewisville",
            "state": "TX",
            "postal_code": "750564592",
            "country_code": "US",
            "telephone_number": "682-683-2301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4545 Heritage Trace Pkwy Ste 1500",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "762448938",
            "country_code": "US",
            "telephone_number": "682-683-2301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9990 Dallas Pkwy Ste 125",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750334137",
            "country_code": "US",
            "telephone_number": "682-683-2301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4150 N Collins St",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760054547",
            "country_code": "US",
            "telephone_number": "682-683-2301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPROLES",
        "first_name": "BLAKLEY",
        "middle_name": "WALKER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-02",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17104",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-007454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.