Ineuroheadachespecialist

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

0102050198 Issued in VA

Legal business name

INEUROHEADACHESPECIALIST

Practice address

7601 Lewinsville Rd
Suite 460
MC Lean, VA 22102-2814

Phone

(703) 828-9492

Fax

(703) 759-5361

NPI assigned

Nov 28, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Mahan Chehrenama, D.O.

Title

Medical Director

Phone

(703) 727-0771

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480291200000",
    "number": "1275076150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 LEWINSVILLE RD",
            "address_2": "SUITE 460",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221022814",
            "telephone_number": "703-828-9492",
            "fax_number": "703-759-5361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 LEWINSVILLE RD",
            "address_2": "SUITE 460",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221022814",
            "telephone_number": "703-828-9492",
            "fax_number": "703-759-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INEUROHEADACHESPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-28",
        "last_updated": "2016-11-28",
        "status": "A",
        "authorized_official_last_name": "CHEHRENAMA",
        "authorized_official_first_name": "MAHAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "703-727-0771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0102050198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI",
            "identifier": "1447220421",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Neurology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; 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.