NPIMap

Organization Active NPI

Orthovirginia, Inc.

  • Multi-Specialty Clinic/Center
  • Bluefield, VA
National Provider Identifier
1649753500
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ORTHOVIRGINIA, INC.
Practice address
111 Sanders Lane
Suite E
Bluefield, VA 24605-9278
Phone
(276) 322-7649
Fax
(276) 322-7822
NPI assigned
Sep 7, 2018
Last updated
Aug 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X
Physical Medicine & Rehabilitation Physician 208100000X
Podiatrist 213E00000X
Multi-Specialty Clinic/Center 261QM1300X Primary
Physical Therapy Clinic/Center 261QP2000X
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X

Addresses

Primary practice location

111 Sanders Lane
Suite E
Bluefield, VA 24605-9278

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 VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040228000320 VA Part B Supplier - Clinic/Group Practice 0547157224 Receives reassigned benefits from 546 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mechanicsville, VA; Midlothian, VA; North Chesterfield, VA; Prince George, VA; Richmond, VA; Virginia Beach, VA; Wytheville, VA; Manassas, VA…
O20210323000770 VA DME Supplier - Multi-Specialty - PhysicianDME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Physician AssistantDME Supplier - Independently-Practicing Physical TherapistDME Supplier - Nurse Practitioner 0547157224 Practice locations: Bluefield, VA

Other NPIs on the same Medicare enrollment 30

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

View all 30

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Orthovirginia Inc111 Sanders LN, Bluefield, VA 24605-9278(540) 595-3744 Canes and/or Crutches|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf Accepts assignmentParticipating since Oct 1, 1984

National Provider Directory

National Provider Directory
Tax ID family
Orthovirginia63 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

111E Saunders Ln
Bluefield, VA 24605

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1649753500",
    "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",
            "fax_number": "804-560-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SANDERS LANE",
            "address_2": "SUITE E",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "246059278",
            "telephone_number": "276-322-7649",
            "fax_number": "276-322-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOVIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-07",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "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": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluefield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.