MEDICARE: ORTHOVIRGINIA, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1376411413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOVIRGINIA, INC

Provider Business Mailing Address
First Line	:	1115 BOULDERS PKWY
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-4067
Country	:	US
Telephone Number	:	804-320-1339
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 S QUINCY ST STE 720
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22206-2281
Country	:	US
Telephone Number	:	804-533-2357
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER ENROLLMENT MANAGER
Name	:	ERICA S TYLER
Credential	:
Telephone Number	:	804-528-1548

Provider Enumeration Date	:	10/29/2025
Last Update Date	:	10/29/2025

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