Unknown Individual – Orthopaedic Foot and Ankle Surgery Physician, NPI 1720054919

Unknown Individual is a healthcare provider. based in Richmond, Virginia. specializing in Orthopaedic Foot and Ankle Surgery Physician. They hold a License No. 0101047689 (VA). The NPI Number for Unknown Individual is 1720054919

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1720054919
Phone
(804) 270-1305
Address
7858 SHRADER RD
Deactivation Date
17 November 2021

Doctor Profile

Medical School Name
TULANE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8043792414
Graduation Year
1981 (45 years ago)
PAC ID
4486794179
Group Practice PAC ID
0547157224
Professional Enrollment ID
I20091210000164

Contacts

Secure Messaging
wvanmanen6889@direct.orthovirginia.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 7858 SHRADER RD

    RICHMOND, VA 23294

    Phone: (804) 270-1305

    Fax: (804) 273-9294

    Type: Location

  • 1115, Boulders Parkway, Chesterfield Village, Chesterfield County, Virginia, 23225, United States

    SUITE 200

    NORTH CHESTERFIELD, VA 232254067

    Phone: (804) 560-5595

    Fax: (804) 560-9029

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 23294)

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Provider's Procedures

Unknown Individual performs procedures in Orthopaedic Foot and Ankle Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ORTHOPEDIC SURGERYVA73630X-ray of foot, minimum of 3 views445276

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547157224View full group profile
NameSpecialtyState
-VA
-VA
Physician AssistantVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
-VA
-VA
-VA
-VA

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1720054919.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Orthopaedic Foot and Ankle Surgery Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Richmond, Virginia may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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