NPIMap

Individual provider Active NPI

Jason Hackenbracht, MD

  • Cardiovascular Disease Physician
  • Lynchburg, VA
National Provider Identifier
1952385452
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
0101057943 Issued in VA
Practice address
2410 Atherholt Rd
Lynchburg, VA 24501-2148
Phone
(434) 200-5252
Fax
(434) 200-2862
NPI assigned
Nov 30, 2005
Last updated
Apr 1, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0101057943 VA Primary

Addresses

Primary practice location

2410 Atherholt Rd
Lynchburg, VA 24501-2148

Mailing address

2410 Atherholt Rd
Lynchburg, VA 24501-2148
Phone (434) 200-5252

Other identifiers 1

IdentifierTypeStateIssuer
010313503MedicaidVA

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
I20040129001225 VA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Nuclear Medicine 9133022858 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Nuclear Medicine
Education
Ohio Medical University, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians
Centra Health, IncGroup PAC ID 6002719713, 17 clinicians

Practice addresses (Care Compare)

1039 Mayberry Crossing Dr
Suite C
Moneta, VA 24121-6414
Phone (540) 297-7840

104 Carolina Ave
Brookneal, VA 24528-2643
Phone (434) 376-2325

115 Ambriar PLZ
Amherst, VA 24521-4741
Phone (434) 946-9565

125 Nationwide Dr
Lynchburg, VA 24502-4272
Phone (434) 200-3908

1280 Main St a
Altavista, VA 24517-1465
Phone (434) 309-1165

1613 Oakwood St
Bedford, VA 24523-1213

16890 Forest Rd
Forest, VA 24551-4059
Phone (434) 200-7210

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033

2025 Tate Springs Rd
Lynchburg, VA 24501-1116
Phone (434) 200-2900

2410 Atherholt Rd
Lynchburg, VA 24501-2148
Phone (434) 200-1800

291 McBride LN
Gretna, VA 24557-2773
Phone (434) 656-1274

3300 Rivermont Ave
Lynchburg, VA 24503-2030
Phone (434) 200-5999

4830 Rucker Rd
Moneta, VA 24121-5281
Phone (540) 297-7181

800 Oak St
Farmville, VA 23901-1199
Phone (434) 315-2998

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Oct 1, 2013 Accepting new patients
Southside Community Hospital, Inc. Past Accepting new patients
Halifax Heart Center PC PastSince Jan 1, 2003 Accepting new patients

Locations

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

291 McBride Ln
Gretna, VA 24557
Phone (434) 656-1274

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

1937 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-6484

2015 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 528-2212

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

2410 Atherholt Rd
Lynchburg, VA 24501
Phone (434) 200-5252

3300 Rivermont Ave
Lynchburg, VA 24503
Phone (434) 200-4668

1039 Mayberry Crossing Dr
Ste C
Moneta, VA 24121
Phone (434) 200-4422

2232 Wilborn Ave
Ste A
South Boston, VA 24592
Phone (434) 572-8977

Organizations & group practices 4

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 11

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1952385452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012148",
            "telephone_number": "434-200-5252",
            "fax_number": "434-200-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012148",
            "telephone_number": "434-200-5252",
            "fax_number": "434-200-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKENBRACHT",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101057943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010313503",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.