Madison Vansavage Maben

Primary specialty

OrthotistTaxonomy code 222Z00000X

License

CO005977 Issued in VA

Practice address

433 Network Sta
Chesapeake, VA 23320

Phone

(757) 892-5300

Fax

(757) 892-5303

NPI assigned

Nov 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coastal Prosthetics & Orthotics, LLC

  • Prosthetic/Orthotic Supplier
  • Norfolk, VA
  • NPI 1558328393
  NPD (past)
• Coastal Prosthetics and Orthotics, LLC

  • Prosthetic/Orthotic Supplier
  • Newport News, VA
  • NPI 1093727117

  Orthotist

  NPD (past)
• Coastal Prosthetics and Orthotics, LLC

  • Prosthetic/Orthotic Supplier
  • Virginia Beach, VA
  • NPI 1386270643

  Orthotist

  NPD (past)

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1639647993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 NETWORK STA",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203851",
            "telephone_number": "757-892-5300",
            "fax_number": "757-892-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 NETWORK STA",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "23320",
            "telephone_number": "757-892-5300",
            "fax_number": "757-892-5303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11818 Rock Landing Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064395",
            "country_code": "US",
            "telephone_number": "757-892-5300",
            "fax_number": "757-892-5303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6320 N Center Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235024009",
            "country_code": "US",
            "telephone_number": "757-889-2530",
            "fax_number": "757-892-5303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "433 Network Sta",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233203851",
            "country_code": "US",
            "telephone_number": "757-892-5300",
            "fax_number": "757-892-5303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANSAVAGE MABEN",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-05",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "VA",
            "license": "CO005977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009190414",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09190414",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyera Vandyke
• Vann Virginia Center for Orthopaedics
• Vann-Virginia Center for Orthopaedics PC
• Vann-Virginia Center for Orthopaedics PC
• Cierra Vann
• Dena Marie Varela, PSYD
• Catherine Vargas
• Jimena Vargas, RBT
• Nicole Julia Varnado, PHARMD
• Elizabeth Virginia Varo, PT

• Orthotist in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Orthotist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.