MEDICARE: CENTRAL VIRGINIA ENDOSCOPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1548193212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL VIRGINIA ENDOSCOPY, LLC

Provider Business Mailing Address
First Line	:	121 NATIONWIDE DR STE B
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24502-4272
Country	:	US
Telephone Number	:	434-384-1862
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 NATIONWIDE DR STE B
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24502-4272
Country	:	US
Telephone Number	:	434-384-1862
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/MANAGING PARTNER
Name	:	DR. PATRICK RICHARD KENNY
Credential	:	DO
Telephone Number	:	434-384-1862

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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