Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacob Albert Wooten, PA-C

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1629648209

Jacob Albert Wooten, PA-C is a Physician Assistant in Lynchburg, Virginia. Qualified in 2021, 5 years ago. Practices with Centra Medical Group LLC, a 717-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
5
Licensed in
VA
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

162 Mallard Ln
Lynchburg, VA 24502-1154
Phone: (434) 420-1816
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110008161 (VA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1629648209
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 28, 2021
Last updated in NPPESOctober 12, 2021
Certification dateOctober 12, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Centra Medical Group Llc — 717 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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