NPIMap

Organization Active NPI

Chippenham & Johnston Willis Sports Medicine, LLC

  • Specialist
  • Midlothian, VA
National Provider Identifier
1467576249
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CHIPPENHAM & JOHNSTON WILLIS SPORTS MEDICINE, LLC
Practice address
5309 Commonwealth Centre Parkway
Suite 100
Midlothian, VA 23112
Phone
(804) 560-6500
Fax
(804) 560-6505
NPI assigned
Mar 19, 2007
Organization subpart
Yes
Parent organization
CJW MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Authorized official

Name
Mr. Hunter Lee Durvin, ATC
Title
Manager
Phone
(804) 560-6511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

5309 Commonwealth Centre Parkway
Suite 100
Midlothian, VA 23112

Mailing address

500 Hioaks Rd
Suite a
Richmond, VA 23225-4061
Phone (804) 560-6500

Other names 1

  • CJW Sports Medicine, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Chippenham Johnston Willis Sports Medicine LLC6 organizations share this tax ID, including this one
Part of
Chippenham Med Ctr Cardgrp

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1115 Boulders Pkwy
Ste 110
North Chesterfield, VA 23225
Phone (804) 560-6500

7101 Jahnke Rd
Ste 200
Richmond, VA 23225
Phone (804) 483-1270

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1467576249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HIOAKS RD",
            "address_2": "SUITE A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232254061",
            "telephone_number": "804-560-6500",
            "fax_number": "804-560-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5309 COMMONWEALTH CENTRE PARKWAY",
            "address_2": "SUITE 100",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23112",
            "telephone_number": "804-560-6500",
            "fax_number": "804-560-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIPPENHAM & JOHNSTON WILLIS SPORTS MEDICINE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CJW MEDICAL CENTER",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "DURVIN",
        "authorized_official_first_name": "HUNTER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "804-560-6511",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ATC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CJW Sports Medicine, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.