Organization Active NPI

Orthovirginia, Inc

  • Multi-Specialty Clinic/Center
  • North Chesterfield, VA
National Provider Identifier
1053471789
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ORTHOVIRGINIA, INC
Practice address
1400 Johnston Willis Drive
Suite B
North Chesterfield, VA 23235-4765
Phone
(804) 379-3840
Fax
(804) 379-9567
NPI assigned
Dec 11, 2006
Last updated
Jun 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Authorized official

Name
Nicole Proffitt
Title
Credentialing & Enrollment
Phone
(804) 533-2357

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

1400 Johnston Willis Drive
Suite B
North Chesterfield, VA 23235-4765

Mailing address

PO Box 715868
Philadelphia, PA 19171-5868
Phone (804) 560-5595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040228000320 VA Part B Supplier - Clinic/Group Practice 0547157224 Receives reassigned benefits from 546 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mechanicsville, VA; Midlothian, VA; North Chesterfield, VA; Prince George, VA; Richmond, VA; Virginia Beach, VA; Wytheville, VA; Manassas, VA…

Other NPIs on the same Medicare enrollment 30

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 30

National Provider Directory

National Provider Directory

Locations

20041 Riverside Commons Plz
Ashburn, VA 20147
Phone (703) 466-0447

1400 Johnston Willis Dr
Ste B
North Chesterfield, VA 23235
Phone (804) 379-3840

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1053471789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 715868",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191715868",
            "telephone_number": "804-560-5595",
            "fax_number": "804-560-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 JOHNSTON WILLIS DRIVE",
            "address_2": "SUITE B",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354765",
            "telephone_number": "804-379-3840",
            "fax_number": "804-379-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOVIRGINIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CREDENTIALING & ENROLLMENT",
        "authorized_official_telephone_number": "804-533-2357"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.