NPIMap

Organization Active NPI

Centra Pace

  • PACE Provider Organization
  • Lynchburg, VA
National Provider Identifier
1861637191
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
CENTRA PACE
Practice address
407 Federal St
Lynchburg, VA 24504-2423
Phone
(434) 200-4190
Fax
(434) 200-6263
NPI assigned
Dec 16, 2008
Organization subpart
Yes
Parent organization
CENTRA HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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

Authorized official

Name
Mr. George C Graham, MBA
Title
Executive Director
Phone
(434) 200-6516

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X VA Primary

Addresses

Primary practice location

407 Federal St
Lynchburg, VA 24504-2423

Mailing address

407 Federal St
Lynchburg, VA 24504-2423
Phone (434) 200-4190

Other names 1

  • Centra PACE Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D1090102Centra Pace - Lynchburg407 Federal Street, Lynchburg, VA 24504Certificate of waiverOct 1, 2026

National Provider Directory

National Provider Directory
Tax ID family
Centra Health Inc Ta L37 organizations share this tax ID, including this one
Part of
Centra Health Inc Ta L

Other organizations with this tax ID 36

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

View all 36

Locations

407 Federal St
Lynchburg, VA 24504
Phone (434) 200-6401

NPI Registry JSON

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402876800000",
    "number": "1861637191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 FEDERAL ST",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245042423",
            "telephone_number": "434-200-4190",
            "fax_number": "434-200-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 FEDERAL ST",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245042423",
            "telephone_number": "434-200-4190",
            "fax_number": "434-200-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRA PACE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRA HEALTH",
        "enumeration_date": "2008-12-16",
        "last_updated": "2014-06-16",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "434-200-6516",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centra PACE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.