NPIMap

Organization Active NPI

Orthovirginia, Inc.

  • Multi-Specialty Clinic/Center
  • Henrico, VA
National Provider Identifier
1104542612
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ORTHOVIRGINIA, INC.
Practice address
12216 W Broad Street
Suite 4B-5
Henrico, VA 23233-1602
Phone
(804) 440-4878
Fax
(804) 200-7124
NPI assigned
Oct 17, 2022
Last updated
Oct 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

12216 W Broad Street
Suite 4B-5
Henrico, VA 23233-1602

Mailing address

PO Box 715868
Philadelphia, PA 19171-5868
Phone (804) 915-1910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

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…
O20230613003613 VA DME Supplier - Multi-Specialty - Physician 0547157224 Practice locations: Henrico, 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
Tax ID family
Orthovirginia63 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

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

View all 14

Locations

12216 W Broad St
Ste 4B5
Richmond, VA 23233
Phone (804) 440-4878

Practitioners & affiliated clinicians

Practitioners 5

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": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1104542612",
    "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": "804-915-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12216 W BROAD STREET",
            "address_2": "SUITE 4B-5",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232331602",
            "telephone_number": "804-440-4878",
            "fax_number": "804-200-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOVIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CREDENTIALING AND ENROLLMENT",
        "authorized_official_telephone_number": "804-533-2357"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.