NPIMap

Organization Active NPI

Colonial Orthopaedics Inc

  • Orthopaedic Surgery Physician
  • Colonial Heights, VA
National Provider Identifier
1811311343
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
0101034297 Issued in VA
Legal business name
COLONIAL ORTHOPAEDICS INC
Practice address
325 Charles Dimmock Parkway
Suite 301
Colonial Heights, VA 23834
Phone
(804) 526-5888
Fax
(804) 526-5401
NPI assigned
Feb 4, 2014
Last updated
Jun 11, 2019By the provider in NPPES
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 15

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110003073 VA
Orthopaedic Surgery Physician 207X00000X 0101034297 VA Primary
Orthopaedic Surgery Physician 207X00000X 0101036726 VA
Orthopaedic Hand Surgery Physician 207XS0106X 0101226595 VA
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 0101231604 VA
Orthopaedic Surgery of the Spine Physician 207XS0117X 0101237849 VA
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 0101045456 VA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 0101052925 VA
Physical Medicine & Rehabilitation Physician 208100000X 0101222130 VA
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 0101235833 VA
Interventional Pain Medicine Physician 208VP0014X 0101224513 VA
Podiatrist 213E00000X 0103000995 VA
Physical Therapist 225100000X 2305005628 VA
Physical Therapy Assistant 225200000X 2306601247 VA
Hand Occupational Therapist 225XH1200X 0119000261 VA

Addresses

Primary practice location

325 Charles Dimmock Parkway
Suite 301
Colonial Heights, VA 23834

Mailing address

325 Charles H Dimmock Pkwy Ste 100
Colonial Heights, VA 23834-2986
Phone (804) 571-5106

Other identifiers 1

IdentifierTypeStateIssuer
1811311343MedicaidVA

National Provider Directory

National Provider Directory
Tax ID family
Colonial Orthopaedics13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

325 Charles H Dimmock Pkwy
Ste 301
Colonial Heights, VA 23834

NPI Registry JSON

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1811311343",
    "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": "804-571-5106",
            "fax_number": "804-530-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 CHARLES DIMMOCK PARKWAY",
            "address_2": "SUITE 301",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "23834",
            "telephone_number": "804-526-5888",
            "fax_number": "804-526-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL ORTHOPAEDICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-04",
        "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": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003073",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101034297",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101036726",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "VA",
            "license": "0101226595",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "VA",
            "license": "0101231604",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "VA",
            "license": "0101237849",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "VA",
            "license": "0101045456",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "VA",
            "license": "0101052925",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101222130",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "VA",
            "license": "0101235833",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "VA",
            "license": "0101224513",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103000995",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305005628",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306601247",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "VA",
            "license": "0119000261",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811311343",
            "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.