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MASTER CENTER FOR ADDICTION MEDICINE
NPI 1477091247
Internal Medicine - Addiction Medicine in Glen Allen, VA

Active since February 01, 2017CLIA Certified · 6 labs
4212 PARK PLACE CT, GLEN ALLEN, VA 23060(804) 332-5950(804) 728-1086 Get Directions Write a Review

NPPES record last updated: January 4, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 4, 2021, Aug 13, 2020, Feb 1, 2017 (3 updates tracked since 2017).

About Master Center For Addiction Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MASTER CENTER FOR ADDICTION MEDICINE (NPI 1477091247) is a healthcare organization registered as an addiction medicine in Glen Allen, Virginia and active in the NPI registry since February 2017. The organization holds 6 active CLIA laboratory certificates, maintains a secondary practice location in Gloucester, and lists James Edward Thompson, Cmo, as its authorized official.

NPPES Registry Identity

NPI1477091247
Entity TypeOrganization
Primary Taxonomy207RA0401X
Legal Business NameVIRGINIA CENTER FOR ADDICTION MEDICINE
Location Address4212 PARK PLACE CTGlen Allen, VA 23060-3314
Mailing Address4212 Park Place CtGlen Allen, VA 23060-3314 · (804) 332-5950 · Fax (804) 728-1086
Phone(804) 332-5950
Fax(804) 728-1086
Organization SubpartNo
Authorized OfficialJames Edward ThompsonCmo · (804) 332-5950
Enumeration DateFebruary 1, 2017
Last NPPES UpdateJanuary 4, 20213 updates tracked since enumeration
NPPES CertifiedJanuary 4, 2021
✔ NPI 1477091247 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RA0401X
License✔ Licensed in VA · 0101246355
Definition
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Also ListedPsychiatry & Neurology · Addiction MedicineTaxonomy 2084A0401X · License 0101015030 (VA)
4212 PARK PLACE CT, Glen Allen, VA 23060
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Other Names 1

Doing Business AsMaster Center For Addiction Medicine

Secondary Practice Location 1

Location 17280 York AveGloucester, VA 23061-5181 · Phone (804) 332-5950 · Fax (804) 728-1086

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Master Center For Addiction Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

16

Medicare enrollment records show 16 clinicians reassign Medicare billing to Master Center For Addiction Medicine, which bills Medicare for the services they deliver. Of these, 6 practice at this address. They are listed nearest first.

Clinicians by Medicare Specialty 4

Nurse Practitioner10
Addiction Medicine3
Mental Health Counselor2
Clinical Social Worker1

Clinicians, nearest first (16)

Brittany Hall, AGNP-C
Nurse Practitioner
NPI 1932871472
4212 PARK PLACE CT
Glen Allen, VA 23060
(804) 332-5950
✔ PECOS✔ Accepts MedicareSame address
Justin Jackson, LPC
Mental Health Counselor
NPI 1235788902
4212 PARK PLACE CT
Glen Allen, VA 23060
(804) 332-5950
✔ PECOS✔ Accepts MedicareSame address
Marci Waggoner, NP
Nurse Practitioner
NPI 1164884714
4212 PARK PLACE CT
Glen Allen, VA 23060
(804) 332-5950
✔ PECOS✔ Accepts MedicareSame address
Kira Bleecher, M.D.
Addiction Medicine
NPI 1164868469
4212 PARK PLACE CT
Glen Allen, VA 23060
(804) 332-5950
✔ PECOS✔ Accepts MedicareSame address
Mary Bowman, ACNP-BC
Nurse Practitioner
NPI 1770869406
4212 PARK PLACE CT
Glen Allen, VA 23060
(804) 332-5950
✔ PECOS✔ Accepts MedicareSame address
James Thompson, MD
Addiction Medicine
NPI 1194913533
4212 PARK PLACE CT
Glen Allen, VA 23060
(804) 332-5950
✔ PECOS✔ Accepts MedicareSame address
Keeley Grimm, APRN
Nurse Practitioner
NPI 1619656386
107 S 5TH ST
Richmond, VA 23219
(804) 819-4016
✔ PECOS✔ Accepts Medicare11 mi
Loren Lee, AGPCNP-BC, RN
Nurse Practitioner
NPI 1588242044
107 S 5TH ST
Richmond, VA 23219
(804) 819-4000
✔ PECOS✔ Accepts Medicare11 mi
Clementine Sekyere
Nurse Practitioner
NPI 1588290894
1213 E CLAY ST
Richmond, VA 23298
(804) 828-9000
✔ PECOS✔ Accepts Medicare11 mi
Shannon Thompson, AGACNP-BC
Nurse Practitioner
NPI 1023511540
1250 E MARSHALL ST
Richmond, VA 23298
(804) 828-0996
✔ PECOS✔ Accepts Medicare11 mi
Shannon Garrett, FNP-C
Nurse Practitioner
NPI 1699096057
4825 S LABURNUM AVE
Richmond, VA 23231
(804) 727-8104
✔ PECOS✔ Accepts Medicare16 mi
Andreas Bienert, LPC, NCC, CSAC
Mental Health Counselor
NPI 1821503160
5477 MOORETOWN RD
Williamsburg, VA 23188
(757) 941-0626
✔ PECOS✔ Accepts Medicare52 mi
Paula Lynch
Clinical Social Worker
NPI 1629686704
739 THIMBLE SHOALS BLVD STE 704
Newport News, VA 23606
(800) 496-3082
✔ PECOS73 mi
Kimberly Kaminer, MD
Addiction Medicine
NPI 1548204084
2208 EXECUTIVE DR STE E
Hampton, VA 23666
(804) 349-4491
✔ PECOS✔ Accepts Medicare77 mi
Winter Mcfarland, FNP-C
Nurse Practitioner
NPI 1023585619
3925 PORTSMOUTH BLVD
Chesapeake, VA 23321
(757) 488-3333
✔ PECOS✔ Accepts Medicare86 mi
Charlotte Hall, FNP-BC
Nurse Practitioner
NPI 1992253934
901 RICE ST NW
Atlanta, GA 30318
(404) 613-3093
✔ PECOS✔ Accepts Medicare468 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 6

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2091209

Virginia Center For Addiction Medicine · Glen Allen, VA
Active · expires Feb 8, 2027
CLIA Number49D2091209
Laboratory TypePhysician Office
Certificate Effective DateFebruary 9, 2025
Certificate Expiration DateFebruary 8, 2027
Laboratory DirectorJames E. Thompson
Laboratory Phone(804) 332-5950
Laboratory LocationVirginia Center For Addiction Medicine4212 Park Place Court, Glen Allen, VA 23060
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2309222

Master Center For Addiction Medicine · Harrisonburg, VA
Active · expires Aug 11, 2028
CLIA Number49D2309222
Laboratory TypePhysician Office
Certificate Effective DateAugust 12, 2026
Certificate Expiration DateAugust 11, 2028
Laboratory DirectorJames Thompson
Laboratory Phone(804) 332-5950
Laboratory LocationMaster Center For Addiction Medicine136 W Elizabeth St, Harrisonburg, VA 22802
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2309223

Master Center For Addiction Medicine · Norfolk, VA
Active · expires Aug 11, 2028
CLIA Number49D2309223
Laboratory TypePhysician Office
Certificate Effective DateAugust 12, 2026
Certificate Expiration DateAugust 11, 2028
Laboratory DirectorJames Thompson
Laboratory Phone(804) 332-5950
Laboratory LocationMaster Center For Addiction Medicine701 South Main St, Suite 100A, Norfolk, VA 23523
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2263151

Master Center For Addiction Medicine · Gloucester, VA
Active · expires Jun 22, 2028
CLIA Number49D2263151
Laboratory TypePhysician Office
Certificate Effective DateJune 23, 2026
Certificate Expiration DateJune 22, 2028
Laboratory DirectorJames Thompson
Laboratory Phone(804) 332-5950
Laboratory LocationMaster Center For Addiction Medicine6760 Main Street, Suite C, Gloucester, VA 23061
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2338443

Master Center For Addiction Medicine · Kilmarnock, VA
Active · expires Feb 10, 2028
CLIA Number49D2338443
Laboratory TypePhysician Office
Certificate Effective DateFebruary 11, 2026
Certificate Expiration DateFebruary 10, 2028
Laboratory DirectorJames Thompson
Laboratory Phone(804) 332-5950
Laboratory LocationMaster Center For Addiction Medicine95 Harris Rd, Bldg 6, Kilmarnock, VA 22482
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2271450

Master Center For Addiction Medicine · North Chesterfield, VA
Active · expires Nov 1, 2026
CLIA Number49D2271450
Laboratory TypePhysician Office
Certificate Effective DateNovember 2, 2024
Certificate Expiration DateNovember 1, 2026
Laboratory DirectorJames Thompson
Laboratory Phone(804) 332-5950
Laboratory LocationMaster Center For Addiction Medicine2505 Pocoshock Place, Suite 101, North Chesterfield, VA 23235
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Virginia Center For Addiction Medicine's NPI number?

The NPI number for Virginia Center For Addiction Medicine is 1477091247. It was assigned to this organization in the NPPES registry on February 1, 2017. The provider is doing business as Master Center For Addiction Medicine.

Where is Virginia Center For Addiction Medicine located?

Virginia Center For Addiction Medicine is located at 4212 Park Place Ct, Glen Allen, VA 23060. The listed phone number is (804) 332-5950.

What is Virginia Center For Addiction Medicine's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.

Is Virginia Center For Addiction Medicine enrolled in Medicare?

Yes. Virginia Center For Addiction Medicine is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Virginia Center For Addiction Medicine?

According to the CMS Revalidation Reassignment List (October 2026 release), 16 clinicians in 4 Medicare specialties reassign their Medicare billing to Virginia Center For Addiction Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (10), Addiction Medicine (3) and Mental Health Counselor (2). Of these, 6 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Virginia Center For Addiction Medicine hold CLIA laboratory certificates?

Yes. 6 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Virginia Center For Addiction Medicine was last updated on January 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.