NPIMap

Organization Active NPI

Orthovirginia, Inc

  • Multi-Specialty Clinic/Center
  • Reston, VA
National Provider Identifier
1679596647
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
1850 Town Center Pkwy
Suite 400
Reston, VA 20190-3219
Phone
(703) 810-5202
NPI assigned
Jul 25, 2006
Reactivated
Apr 1, 2022
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

1850 Town Center Pkwy
Suite 400
Reston, VA 20190-3219

Mailing address

PO Box 715868
Philadelphia, PA 19171-5868
Phone (804) 915-1910

Other names 1

  • Commonwealth Orthopaedics & Rehabilitation PC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

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
This NPI is an additional NPI on the enrollment
Practice locations: Alexandria, VA; Reston, VA; McLean, VA; MC Lean, VA; Herndon, VA; Fairfax, VA; Burke, VA; Arlington, VA
O20150611000604 VA DME Supplier - Multi-Specialty - PhysicianDME Supplier - Nurse PractitionerDME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Physician Assistant 0547157224 Practice locations: Reston, 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
Tax ID family
Orthovirginia Imaging63 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

1635 N George Mason Dr
Ste 110
Arlington, VA 22205
Phone (703) 522-3515

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654214400000",
    "number": "1679596647",
    "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": "1850 TOWN CENTER PKWY",
            "address_2": "SUITE 400",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903219",
            "telephone_number": "703-810-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOVIRGINIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "deactivation_date": "2022-02-11",
        "reactivation_date": "2022-04-01",
        "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": [
        {
            "organization_name": "Commonwealth Orthopaedics & Rehabilitation PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Commonwealth Orthopaedics & Rehabilitation PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Reston, 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.