Cerebrum MD, PLLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

101239497 Issued in VA

Legal business name

CEREBRUM MD, PLLC

Practice address

8230 Boone Blvd
Suite 360
Vienna, VA 22182-2621

Phone

(703) 748-1000

Fax

(703) 748-1010

NPI assigned

Mar 19, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Joseph C Watson, MD

Title

Owner

Phone

(703) 748-1000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1174940985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8230 BOONE BLVD",
            "address_2": "SUITE 360",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822621",
            "telephone_number": "703-748-1000",
            "fax_number": "703-748-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8230 BOONE BLVD",
            "address_2": "SUITE 360",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822621",
            "telephone_number": "703-748-1000",
            "fax_number": "703-748-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEREBRUM MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-19",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-748-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": "101239497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Raina Elizabeth Ceryak, PT, DPT
• Wonje Cha, D.D.S
• Mark Allen Chalfant, D.C.
• Stephen W. Chang, M.D.
• Woody Chang, M.D.

• Neurological Surgery Physician in Vienna, VA
• Providers in Vienna, VA by specialty
• Neurological Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.