Eastern VA Orthotics & Prosthetics, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

EASTERN VA ORTHOTICS & PROSTHETICS, INC

Practice address

13394 Chesapeake PL
Carrollton, VA 23314-3388

Phone

(757) 850-2835

Fax

(757) 850-3409

NPI assigned

Aug 8, 2006

Last updated

May 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Lisa L Crouse

Title

Owner/Admin

Phone

(757) 850-2835

Specialties & licenses 2

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1326058058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3511",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236630511",
            "telephone_number": "757-850-2835",
            "fax_number": "757-850-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13394 CHESAPEAKE PL",
            "city": "CARROLLTON",
            "state": "VA",
            "postal_code": "233143388",
            "telephone_number": "757-850-2835",
            "fax_number": "757-850-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN VA ORTHOTICS & PROSTHETICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "CROUSE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/ADMIN",
        "authorized_official_telephone_number": "757-850-2835",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "VA",
            "license": "C12887",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "073161",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009190384",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1326058058",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1326058058",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Carrollton",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Carrollton",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Carrollton",
            "address_1": "13394 Chesapeake Pl",
            "city": "Carrollton",
            "state": "VA",
            "country_code": "US",
            "postal_code": "233143388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Carrollton, VA
• Providers in Carrollton, VA by specialty
• Prosthetic/Orthotic Supplier in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.