Organization
ORTHOVIRGINIA, INC.
Active
Parent organization
ORTHOVIRGINIA, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORTHOVIRGINIA, INC.
Authorized official
NICOLE PROFFITT (CREDENTIALING & ENROLLMENT)
(804) 533-2357
Entity
Organization
Contact information
Practice address
1920 BALLENGER AVENUE, SUITE 200, ALEXANDRIA, VA 22314-6818
(703) 810-5208
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-4067
(804) 915-1910
(804) 560-9029
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/03/2020
Last updated
08/17/2023
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