Orthovirginia Inc.
Organization Active NPI Multi-Specialty Clinic/Center · Fairfax, VA
NPI 1588066740 · NPPES record last updated Jun 3, 2022
Key facts
- NPI
- 1588066740
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- ORTHOVIRGINIA INC.
- Practice address
- 11240 Waples Mill Rd
Suite 403
Fairfax, VA 22030-6078 - Phone
- (703) 383-6424
- NPI assigned
- Sep 19, 2014
- Organization subpart
- No
Authorized official
- Name
- Nicole Proffitt
- Title
- Credentialing/Enrollment
- Phone
- (804) 533-2357
Other NPIs on the same Medicare enrollment 21
Practitioners 256
-
Jessalynn Adam, MD
-
Eligio Aguhob III, PT, DPT
-
George Aguiar, MD
-
Vignesh Alamanda, MD
-
Lauren Anderson, DPT
-
Gordon L Avery, MD
-
Alexandra Avilov, DPT
-
Elshaday S. Belay, M.D.
-
Johnathan Alexander Bernard, MD, MPH
-
Alexandra Bingnear, MSN, AGACNP-BC
-
Keenan David Brown, PT, DPT
-
Katherine Durham Canestrano, OTR/L, CHT
-
Natalia Castro, FNP
-
Ronald C Childs, MD
-
Alexander W Coffelt, PT, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150102000273 | DC | Part B Supplier - Clinic/Group Practice | 0547157224 |
Receives reassigned benefits from 252 practitioners 27 other NPIs on this enrollment Practice locations: Alexandria, VA; Reston, VA; McLean, VA; MC Lean, VA; Herndon, VA; Fairfax, VA; Burke, VA; Arlington, VA |
National Provider Directory
Locations
1850 Town Center Pkwy
Ste 403
Reston, VA 20190
Phone (703) 736-2806
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
11240 Waples Mill Rd
Suite 403
Fairfax, VA 22030-6078
Mailing address
PO Box 715868
Philadelphia, PA 19171-5868
Phone (804) 915-1910
Other providers in Fairfax, VA
- Thu-Nga H Ortega
- Orthocare Physical Therapy Center, LLC
- Orthocare Solutions Inc
- Orthotic Prosthetic Center, Inc.
- Orthotic Solutions, LLC
- Orthovirginia Inc.
- Orthovirginia, Inc
- Orthovirginia, Inc.
- Bibiana G. Ortiz-Levine
- Adrian Ortiz
All providers in Fairfax, VA · Multi-Specialty Clinic/Center in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.