NPIMap

Organization Active NPI

Orthovirginia, Inc

  • Multi-Specialty Clinic/Center
  • Burke, VA
National Provider Identifier
1891718854
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
5201 A Lyngate Court
Burke, VA 22015-1695
Phone
(703) 810-5221
NPI assigned
Jul 25, 2006
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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Physical Therapy Clinic/Center 261QP2000X NU
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X NU
Orthopaedic Surgery Physician 207X00000X NU

Addresses

Primary practice location

5201 A Lyngate Court
Burke, VA 22015-1695

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

Enrollment records 1

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

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

Practitioners & affiliated clinicians

Practitioners 11

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": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1891718854",
    "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": "5201 A LYNGATE COURT",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151695",
            "telephone_number": "703-810-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOVIRGINIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "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": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Burke, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.