Provider Demographics
NPI:1639125271
Name:VANN-VIRGINIA CENTER FOR ORTHOPAEDICS PC
Entity Type:Organization
Organization Name:VANN-VIRGINIA CENTER FOR ORTHOPAEDICS PC
Other - Org Name:ATLANTIC ORTHOPAEDIC SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGGE
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:757-321-3398
Mailing Address - Street 1:230 CLEARFIELD AVE
Mailing Address - Street 2:SUITE 124
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1832
Mailing Address - Country:US
Mailing Address - Phone:757-321-3300
Mailing Address - Fax:757-321-3332
Practice Address - Street 1:6160 KEMPSVILLE CIR
Practice Address - Street 2:SUITE 200 B
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3933
Practice Address - Country:US
Practice Address - Phone:757-321-3300
Practice Address - Fax:757-455-5598
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VANN-VIRGINIA CENTER FOR ORTHOAPEDICS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-25
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101041556207X00000X
VA2305003416225100000X
VA0119003467225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACE8289OtherMEDICARE RAILROAD
VA1230520008OtherDMERC
VA1230520008Medicare NSC
VAC05501Medicare PIN