Healthcare Provider Details

I. General information

NPI: 1669526711
Provider Name (Legal Business Name): HAMPTON ROADS ORTHOPAEDIC & SPORTS MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 THIMBLE SHOALS BLVD STE 120
NEWPORT NEWS VA
23606-4562
US

IV. Provider business mailing address

730 THIMBLE SHOALS BLVD STE 130
NEWPORT NEWS VA
23606-4562
US

V. Phone/Fax

Practice location:
  • Phone: 757-873-1554
  • Fax: 757-873-3239
Mailing address:
  • Phone: 757-926-4351
  • Fax: 757-534-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. WENDY JACKSON
Title or Position: CHIEF INFORMATION OFFICER
Credential:
Phone: 757-873-1554