NPIMap

Organization Active NPI

Orthovirginia Inc.

  • Multi-Specialty Clinic/Center
  • Fairfax, VA
National Provider Identifier
1588066740
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 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
Last updated
Jun 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 21

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 21

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 256

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.

View all 256

NPI Registry JSON

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654214400000",
    "number": "1588066740",
    "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": "11240 WAPLES MILL RD",
            "address_2": "SUITE 403",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306078",
            "telephone_number": "703-383-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOVIRGINIA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-19",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CREDENTIALING/ENROLLMENT",
        "authorized_official_telephone_number": "804-533-2357"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.