Crowell Reconstructive Surgery PLLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

CROWELL RECONSTRUCTIVE SURGERY PLLC

Practice address

1860 Town Center Dr Ste 180
Reston, VA 20190-5905

Phone

(571) 525-2316

Fax

(571) 313-0415

NPI assigned

Nov 26, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Penny Marshall

Title

Patient Accounts

Phone

(443) 646-5001

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bruce M Freedman, MD

  • Plastic and Reconstructive Surgery Physician
  • Reston, VA
  • NPI 1316922503

  DC

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588204800000",
    "number": "1003385709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 TOWN CENTER DR STE 180",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905905",
            "telephone_number": "571-525-2316",
            "fax_number": "571-313-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 TOWN CENTER DR STE 180",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905905",
            "telephone_number": "571-525-2316",
            "fax_number": "571-313-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWELL RECONSTRUCTIVE SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-26",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "443-646-5001"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Cranford
• Melissa Y Crespo, LPC
• Cribcrafters
• Marli Criniti, LPC
• Crossroad Clinics PLC
• Jose Ivan Cruz Chavez
• Ana Cruz
• Loredana Licchi Cunningham, RD
• Edward Lee Curtis III, LPC
• Custom Care Team, Inc.

• Plastic Surgery Physician in Reston, VA
• Providers in Reston, VA by specialty
• Plastic Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.