NPIMap

Organization Active NPI

PWNC PC Corp

  • Specialist
  • Manassas, VA
National Provider Identifier
1184707796
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101059282 Issued in VA
Legal business name
PWNC PC CORP
Practice address
8650 Sudley Rd
Suite 300
Manassas, VA 20110-4419
Phone
(703) 369-0600
Fax
(703) 369-7487
NPI assigned
Oct 24, 2006
Last updated
Oct 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Authorized official

Name
Dr. Yvette C Sandoval, M.D.NPI 1619956703
Title
Neuro President
Phone
(703) 369-0600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 0101059282 VA Primary

Addresses

Primary practice location

8650 Sudley Rd
Suite 300
Manassas, VA 20110-4419

Mailing address

8650 Sudley Rd
Suite 300
Manassas, VA 20110-4419
Phone (703) 369-0600

Other identifiers 1

IdentifierTypeStateIssuer
0007111673MedicaidVA

Other names 1

  • Prince William Neuroscience Center Former legal business name

National Provider Directory

National Provider Directory

Locations

8650 Sudley Rd
Ste 300
Manassas, VA 20110
Phone (703) 369-0600

9625 Surveyor Ct
Ste 230
Manassas, VA 20110
Phone (913) 940-4504

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1184707796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8650 SUDLEY RD",
            "address_2": "SUITE 300",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104419",
            "telephone_number": "703-369-0600",
            "fax_number": "703-369-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8650 SUDLEY RD",
            "address_2": "SUITE 300",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104419",
            "telephone_number": "703-369-0600",
            "fax_number": "703-369-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PWNC PC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "NEURO PRESIDENT",
        "authorized_official_telephone_number": "703-369-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101059282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007111673",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prince William Neuroscience Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.