OrganizationActive
Old Dominion Orthopaedics and Sports Medicine, PC
NPI 1073564951 · Orthopaedic Surgery Physician · Manassas, VA
Provider details
- NPI number
- 1073564951
- Entity type
- Organization
- Primary specialty
- Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Evelyn Gantt, Billing Manager(703) 369-9070
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8644 Sudley Rd
Ste 308
Manassas, VA 20110-4417
Phone: (703) 369-9070
Fax: (703) 369-9240
Street-level locationGet directions
Mailing address
8644 Sudley Rd
Manassas, VA 20110-4425
Other names (DBA / former)
- Doing business as
- Northern Virginia Orthopaedic Specialist
Registry dates
- Enumerated
- 2006-05-15
- Last updated
- 2023-02-02
- Certified
- 2023-02-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.