NPIMap

Organization Active NPI

Chippenham & Johnston Willis Sports Medicine, LLC

Doing business as CJW Sports Medicine, LLC

  • Specialist
  • Midlothian, VA
National Provider Identifier
1770813230
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CHIPPENHAM & JOHNSTON WILLIS SPORTS MEDICINE, LLC
Doing business as
CJW Sports Medicine, LLC
Practice address
11621 Robious Rd
Midlothian, VA 23113-2349
Phone
(804) 560-6500
Fax
(804) 560-6505
NPI assigned
Jan 6, 2010
Last updated
Jan 7, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
CHIPPENHAM & JOHNSTON WILLIS HOSPITALSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Authorized official

Name
Mr. Hunter Lee Durvin, ATC
Title
Manager
Phone
(804) 560-6511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

11621 Robious Rd
Midlothian, VA 23113-2349

Mailing address

500 Hioaks Rd
Suite a
Richmond, VA 23225-4061
Phone (804) 560-6500

Other names 1

  • CJW Sports Medicine, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Chippenham Johnston Willis Sports Medicine LLC6 organizations share this tax ID, including this one
Part of
Chippenham Johnston-W

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1770813230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HIOAKS RD",
            "address_2": "SUITE A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232254061",
            "telephone_number": "804-560-6500",
            "fax_number": "804-560-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11621 ROBIOUS RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231132349",
            "telephone_number": "804-560-6500",
            "fax_number": "804-560-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIPPENHAM & JOHNSTON WILLIS SPORTS MEDICINE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHIPPENHAM & JOHNSTON WILLIS HOSPITALS",
        "enumeration_date": "2010-01-06",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "DURVIN",
        "authorized_official_first_name": "HUNTER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "804-560-6511",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ATC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CJW Sports Medicine, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.