# CENTRA MEDICAL GROUP, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CENTRA MEDICAL GROUP, LLC
- **Other names:** Piedmont Primecare-Centra Medical Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1285931089
- **Legal business name:** CENTRA MEDICAL GROUP, LLC
- **Authorized official:** LEWIS ADDISON (CFO)
- **Authorized official phone:** (434) 200-3656

## Contact information

- **Practice address:** 404 AIRPORT DR, SUITE A, DANVILLE, VA 24540-5196
- **Practice address phone:** (434) 791-2612
- **Mailing address:** 1204 FENWICK DR, LYNCHBURG, VA 24502-2112

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/15/2011
- **Last updated:** 11/14/2012