NPIMap

Organization Active NPI

Harbour Sports Medicine

  • Orthopaedic Surgery Physician
  • Suffolk, VA
National Provider Identifier
1487800876
Registry record updated Aug 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
01010321 Issued in VA
Legal business name
HARBOUR SPORTS MEDICINE
Practice address
5818 Harbour View Blvd # D
Suite 150
Suffolk, VA 23435-3315
Phone
(757) 215-1400
Fax
(757) 215-1410
NPI assigned
Aug 18, 2008
Organization subpart
Yes
Parent organization
WARDELL ORTHOPAEDICS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 18, 2008

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

Authorized official

Name
Dr. Arthur W Wardell, M.D.
Title
President, Owner
Phone
(757) 215-1400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X 01010321 VA Primary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X 01010321 VA

Addresses

Primary practice location

5818 Harbour View Blvd # D
Suite 150
Suffolk, VA 23435-3315

Mailing address

5818 Harbour View Blvd # D
Suite 150
Suffolk, VA 23435-3315
Phone (757) 215-1400

Other identifiers 2

IdentifierTypeStateIssuer
010080533MedicaidVA
1548289796OtherVANPI

National Provider Directory

National Provider Directory
Part of
Wardell Orthopaedics PC

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1487800876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5818 HARBOUR VIEW BLVD # D",
            "address_2": "SUITE 150",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353315",
            "telephone_number": "757-215-1400",
            "fax_number": "757-215-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5818 HARBOUR VIEW BLVD # D",
            "address_2": "SUITE 150",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353315",
            "telephone_number": "757-215-1400",
            "fax_number": "757-215-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOUR SPORTS MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WARDELL ORTHOPAEDICS, P.C.",
        "enumeration_date": "2008-08-18",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "WARDELL",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT, OWNER",
        "authorized_official_telephone_number": "757-215-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "01010321",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "VA",
            "license": "01010321",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010080533",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1548289796",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.