Centra Medical Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CENTRA MEDICAL GROUP, LLC

Doing business as

Piedmont Primecare-Centra Medical Group (DME)

Practice address

130 Enterprise Dr
Danville, VA 24540-4070

Phone

(434) 791-2273

NPI assigned

Dec 6, 2010

Last updated

Nov 14, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

CENTRA MEDICAL GROUP, LLCAs reported in NPPES

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

Authorized official

Name

Lewis Addison

Title

Cfo

Phone

(434) 200-3656

Specialties & licenses 1

Addresses

Other names 1

• Piedmont Primecare-Centra Medical Group (DME) Doing business as

Part of

Centra Health Professional Services

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352851200000",
    "number": "1932402484",
    "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": "130 ENTERPRISE DR",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245404070",
            "telephone_number": "434-791-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRA MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRA MEDICAL GROUP, LLC",
        "enumeration_date": "2010-12-06",
        "last_updated": "2012-11-14",
        "status": "A",
        "authorized_official_last_name": "ADDISON",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "434-200-3656"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont Primecare-Centra Medical Group (DME)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Centra Health Professional Services, LLC (Centra Medical & Surgical Specialists)
• Centra Health Professional Services, LLC (Centra Medical Group)
• Centra Health, Inc. Community Mental Health Programs
• Centra Medical Group, LLC (Piedmont Primecare-Centra Medical Group)
• Centra Medical Group, LLC (Centra Danville Medical Center)
• Central Vision, P.C.
• Jennifer Kristine Chacon, SLP
• Carrington Atkins Chambers, LPC
• Zenise Ronnae Chambers
• Randy Michael Chan, D.O.

• Family Medicine Physician in Danville, VA
• Providers in Danville, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.