NPIMap

Organization Active NPI

Prince William Orthopaedics Hand Surgery Sports Medicine Center,LLC

  • Medical Physician Assistant
  • Manassas, VA
National Provider Identifier
1043627862
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110004667 Issued in VA
Legal business name
PRINCE WILLIAM ORTHOPAEDICS HAND SURGERY SPORTS MEDICINE CENTER,LLC
Practice address
8525 Rolling Rd
Suite 300
Manassas, VA 20110
Phone
(703) 393-1667
Fax
(703) 393-2517
NPI assigned
Jul 14, 2014
Organization subpart
Yes
Parent organization
A DIVISON OF CENTERS FOR ADVANCED ORTHOPAEDICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Authorized official

Name
Richard Robinson
Title
Coo
Phone
(301) 637-8712

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 0110004667 VA
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X 0110004667 VA Primary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X 0110004667 VA

Addresses

Primary practice location

8525 Rolling Rd
Suite 300
Manassas, VA 20110

Mailing address

6707 Democracy Blvd Ste 504
Bethesda, MD 20817-1166
Phone (703) 393-1667

National Provider Directory

National Provider Directory
Tax ID family
Centers for Adv Ortho LLC125 organizations share this tax ID, including this one
Part of
Centers for Adv Ortho LLC

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1043627862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6707 DEMOCRACY BLVD STE 504",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171166",
            "telephone_number": "703-393-1667",
            "fax_number": "703-393-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8525 ROLLING RD",
            "address_2": "SUITE 300",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "20110",
            "telephone_number": "703-393-1667",
            "fax_number": "703-393-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCE WILLIAM ORTHOPAEDICS HAND SURGERY SPORTS MEDICINE CENTER,LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "A DIVISON OF CENTERS FOR ADVANCED ORTHOPAEDICS",
        "enumeration_date": "2014-07-14",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "301-637-8712"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004667",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110004667",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110004667",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.