Active NPI
Familyorthopaedics and Sports Medicine of Northern Virginia P.C.
- Specialist
- Woodbridge, VA
National Provider Identifier
1003969049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 0101029792
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6400973 | Medicaid | VA | |
| 6325327 | Medicaid | VA |
National Provider Directory
National Provider DirectoryLocations
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.