NPIMap

Organization Active NPI

Colonial Orthopaedics, Inc

  • Orthopaedic Surgery Physician
  • Colonial Heights, VA
National Provider Identifier
1689600447
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
0101036726 Issued in VA
Legal business name
COLONIAL ORTHOPAEDICS, INC
Practice address
325 Charles H Dimmock Pkwy Ste 100
Colonial Heights, VA 23834-2986
Phone
(804) 526-5888
Fax
(804) 526-5401
NPI assigned
Jun 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Jennifer Bailey
Title
Credentialing Specialist
Phone
(804) 571-5106

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X 0101036726 VA Primary
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X 0101226595 VA
Adult Reconstructive Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0114X 0101231604 VA
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X 0101237849 VA
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0004X 0101045456 VA
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X 0101052925 VA

Addresses

Primary practice location

325 Charles H Dimmock Pkwy Ste 100
Colonial Heights, VA 23834-2986

Mailing address

325 Charles H Dimmock Pkwy Ste 100
Colonial Heights, VA 23834-2986
Phone (804) 526-5888

Other practice location 1

6055 Harbour Park Dr
Midlothian, VA 23112-2160
Phone (804) 526-5888

Other identifiers 12

IdentifierTypeStateIssuer
010190096MedicaidVA
010190037MedicaidVA
010190606MedicaidVA
010193419MedicaidVA
010194911MedicaidVA
180887OtherVAANTHEM-DHILLON
180889OtherVAANTHEM-MARQUEEN
180890OtherVAANTHEM-PRAKASH
010195063MedicaidVA
180888OtherVAANTHEM-KALLURI
180891OtherVAANTHEM-SARAIYA
180892OtherVAANTHEM-SRIVASTAVA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1689600447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 CHARLES H DIMMOCK PKWY STE 100",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342986",
            "telephone_number": "804-526-5888",
            "fax_number": "804-526-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 CHARLES H DIMMOCK PKWY STE 100",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342986",
            "telephone_number": "804-526-5888",
            "fax_number": "804-526-5401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6055 Harbour Park Dr",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "VA",
            "postal_code": "231122160",
            "country_code": "US",
            "telephone_number": "804-526-5888",
            "fax_number": "804-526-5401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLONIAL ORTHOPAEDICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "804-571-5106"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101036726",
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "VA",
            "license": "0101226595",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "VA",
            "license": "0101231604",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "VA",
            "license": "0101237849",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "VA",
            "license": "0101045456",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "VA",
            "license": "0101052925",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010190096",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010190037",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010190606",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010193419",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010194911",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-DHILLON",
            "identifier": "180887",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-MARQUEEN",
            "identifier": "180889",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-PRAKASH",
            "identifier": "180890",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010195063",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-KALLURI",
            "identifier": "180888",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-SARAIYA",
            "identifier": "180891",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-SRIVASTAVA",
            "identifier": "180892",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.