Active NPI
Ortho Oic Orthopaedic Immediate Care, LLC
- Urgent Care Clinic/Center
- Arlington, VA
National Provider Identifier
1104394766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urgent Care Clinic/Center
- Legal business name
- ORTHO OIC ORTHOPAEDIC IMMEDIATE CARE, LLC
- Practice address
- 1701 Clarendon Blvd Ste 120
Arlington, VA 22209-4800 - Phone
- (703) 566-6359
- Fax
- (703) 566-6360
- NPI assigned
- Nov 12, 2018
- 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
- Dr. Lonnie D. Davis, MD
- Title
- Managing Member
- Phone
- (703) 566-6359
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Primary |
Addresses
Primary practice location
1701 Clarendon Blvd Ste 120
Arlington, VA 22209-4800
Mailing address
1701 Clarendon Blvd Ste 120
Arlington, VA 22209-4800
Phone (703) 566-6359
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181228001911 | DC | Part B Supplier - Clinic/Group Practice | 6507101128 |
Receives reassigned benefits from 4 practitioners Practice locations: Arlington, VA |
National Provider Directory
National Provider DirectoryInteroperability endpoints
- https://api.platform.athenahealth.com/18844/brand/1/csg/1/fhir/r4
Practitioners 4
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": "1541980800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1599523200000",
"number": "1104394766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 CLARENDON BLVD STE 120",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222094800",
"telephone_number": "703-566-6359",
"fax_number": "703-566-6360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 CLARENDON BLVD STE 120",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222094800",
"telephone_number": "703-566-6359",
"fax_number": "703-566-6360"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ORTHO OIC ORTHOPAEDIC IMMEDIATE CARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-11-12",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A",
"authorized_official_last_name": "DAVIS",
"authorized_official_first_name": "LONNIE",
"authorized_official_middle_name": "D.",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "703-566-6359",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.