Organization Active NPI

Familyorthopaedics and Sports Medicine of Northern Virginia P.C.

  • Specialist
  • Woodbridge, VA
National Provider Identifier
1003969049
Registry record updated Oct 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101029792 Issued in VA
Legal business name
FAMILYORTHOPAEDICS AND SPORTS MEDICINE OF NORTHERN VIRGINIA P.C.
Practice address
2010 Opitz Blvd Ste C
Woodbridge, VA 22191-3359
Phone
(703) 690-4992
NPI assigned
Jan 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2010

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

Authorized official

Name
Sharon H. Lowery
Title
Administrator
Phone
(703) 801-1070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 0101029792 VA Primary

Addresses

Primary practice location

2010 Opitz Blvd Ste C
Woodbridge, VA 22191-3359

Mailing address

2010 Opitz Blvd Ste C
Woodbridge, VA 22191-3359
Phone (703) 690-4992

Other identifiers 2

IdentifierTypeStateIssuer
6400973MedicaidVA
6325327MedicaidVA

National Provider Directory

National Provider Directory

Locations

2010 Opitz Blvd
Ste C
Woodbridge, VA 22191
Phone (703) 690-1152

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286841600000",
    "number": "1003969049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 OPITZ BLVD STE C",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913359",
            "telephone_number": "703-690-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 OPITZ BLVD STE C",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913359",
            "telephone_number": "703-690-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILYORTHOPAEDICS AND SPORTS MEDICINE OF NORTHERN VIRGINIA P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-21",
        "last_updated": "2010-10-12",
        "status": "A",
        "authorized_official_last_name": "LOWERY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "703-801-1070"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101029792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6400973",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6325327",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.