NPIMap

Organization Active NPI

Centra Health Professional Services, LLC

Doing business as The Wound Care Center

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Lynchburg, VA
National Provider Identifier
1902834948
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
Legal business name
CENTRA HEALTH PROFESSIONAL SERVICES, LLC
Doing business as
The Wound Care Center
Practice address
3300 Rivermont Ave
Lynchburg, VA 24503-2030
Phone
(434) 947-7477
NPI assigned
Jun 29, 2006
Last updated
Mar 4, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRA HEALTH PROFESSIONAL SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X NU Primary

Addresses

Primary practice location

3300 Rivermont Ave
Lynchburg, VA 24503-2030

Mailing address

1204 Fenwick Dr
Lynchburg, VA 24502-2112

Other names 1

  • The Wound Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902834948. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
3300 Rivermont Ave
Lynchburg, VA 24503-2030
Other Hospital Practice Location
Hospital subgroups
Acute care

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

Other NPIs on the same Medicare enrollment 39

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

View all 39

Care Compare: Hospital

Medicare Care Compare
Listed as
Centra Health - Lynchburg Gen HospitalCCN 490021 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Centra Health Professional Services106 organizations share this tax ID, including this one
Part of
Centra Health Professional Services

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Ownership & related parties

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 DirectorBoard Member Jan 1, 2023
Robert Tonkinson Individual Corporate OfficerCfo Jan 1, 2025
Gloria Witt Individual Corporate DirectorBoard 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 DirectorBoard 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 OfficerCeo 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

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1,123

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

View all 1,123

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1902834948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 FENWICK DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245022112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 RIVERMONT AVE",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245032030",
            "telephone_number": "434-947-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRA HEALTH PROFESSIONAL SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRA HEALTH PROFESSIONAL SERVICES, LLC",
        "enumeration_date": "2006-06-29",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "TWEEDY",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "434-947-5047"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Wound Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.