NPIMap

Individual provider Active NPI

Charles H Coggin III, MD

  • Family Medicine Physician
  • Lynchburg, VA
National Provider Identifier
1881677565
Registry record updated Feb 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101840609 Issued in VA
Practice address
1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone
(434) 200-5895
Fax
(434) 200-7529
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101840609 VA Primary

Addresses

Primary practice location

1901 Tate Springs Rd
Lynchburg, VA 24501-1109

Mailing address

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 200-5895

Other identifiers 3

IdentifierTypeStateIssuer
005643864MedicaidVA
214240OtherANTHEM
080163992OtherMEDICARE RAILROAD PROVIDER NUMBER

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
I20071116000446 VA Practitioner - HospitalistPractitioner - Family Practice 1456319292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
University of South Carolina School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

1613 Oakwood St
Bedford, VA 24523-1213

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101840609VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC Family Medicine CurrentSince Aug 1, 2011 Accepting new patients

Locations

1615 Oakwood St
Ste D
Bedford, VA 24523
Phone (540) 586-3089

1615 Oakwood St
Ste B
Bedford, VA 24523
Phone (540) 586-3089

800 Oak St
Farmville, VA 23901
Phone (434) 315-2530

2010 Atherholt Rd
Lynchburg, VA 24501
Phone (434) 200-3656

2215 Landover Pl
Lynchburg, VA 24501
Phone (434) 947-3900

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

Organizations & group practices 1

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 9

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676678400000",
    "number": "1881677565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 TATE SPRINGS RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011109",
            "telephone_number": "434-200-5895",
            "fax_number": "434-200-7529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 TATE SPRINGS RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011109",
            "telephone_number": "434-200-5895",
            "fax_number": "434-200-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGGIN",
        "first_name": "CHARLES",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2023-02-18",
        "certification_date": "2023-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101840609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005643864",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "214240",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PROVIDER NUMBER",
            "identifier": "080163992",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.