Individual provider Active NPI

Dwight Stephen Oldham, M.D.

  • Specialist
  • Lynchburg, VA
National Provider Identifier
1851334619
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101028991 Issued in VA
Practice address
1701 Thomson Dr
Suite 200
Lynchburg, VA 24501-1118
Phone
(434) 200-5925
Fax
(434) 200-6254
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101028991 VA Primary

Addresses

Primary practice location

1701 Thomson Dr
Suite 200
Lynchburg, VA 24501-1118

Mailing address

1701 Thomson Dr
Suite 200
Lynchburg, VA 24501-1118
Phone (434) 200-5925

Other identifiers 1

IdentifierTypeStateIssuer
006094546MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101028991VAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1851334619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 THOMSON DR",
            "address_2": "SUITE 200",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011118",
            "telephone_number": "434-200-5925",
            "fax_number": "434-200-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 THOMSON DR",
            "address_2": "SUITE 200",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011118",
            "telephone_number": "434-200-5925",
            "fax_number": "434-200-6254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDHAM",
        "first_name": "DWIGHT",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101028991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006094546",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.