Churchill G Dunn II, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0101027347 Issued in VA

Practice address

131 Elden St #150
Herndon, VA 20170-4876

Phone

(703) 402-4941

Fax

(703) 430-9293

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• C Gibson Dunn Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fairfax County, Virginia

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fairfax, VA
  • NPI 1154356244
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1336185503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 ELDEN ST SUITE 150",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "20170",
            "telephone_number": "703-402-4941",
            "fax_number": "703-430-9293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 ELDEN ST #150",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704876",
            "telephone_number": "703-402-4941",
            "fax_number": "703-430-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN",
        "first_name": "CHURCHILL",
        "middle_name": "G",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101027347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C",
            "last_name": "DUNN",
            "middle_name": "GIBSON",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dulles Family Medicine P.C.
• Rebecca Ashley Dumas, BCBA
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• Jodi Lee Eanes, LPC
• Bryan Eckert, PT, DPT

• Psychiatry Physician in Herndon, VA
• Providers in Herndon, VA by specialty
• Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.