Active NPI
Jonathan L Shurberg, MD
- Specialist
- Manassas, VA
National Provider Identifier
1417952227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 0101027526
- Practice address
- 8640 Sudley Rd Ste 201
Manassas, VA 20110-4404 - Phone
- (703) 368-6819
- Fax
- (703) 330-2923
- NPI assigned
- Jun 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 0101027526 | VA | Primary |
Addresses
Primary practice location
8640 Sudley Rd Ste 201
Manassas, VA 20110-4404
Mailing address
8640 Sudley Rd Ste 201
Manassas, VA 20110-4404
Phone (703) 368-6819
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2277940001 | Other | VA | CIGNA |
| 006065155 | Medicaid | VA | |
| 071108 | Other | VA | ANTHEM/MANASSAS |
| 34542 | Other | VA | MAMSI |
| 92130001 | Other | VA | CAREFIRST |
| 071112 | Other | VA | ANTHEM/WARRENTON |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349395200000",
"number": "1417952227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8640 SUDLEY RD STE 201",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201104404",
"telephone_number": "703-368-6819",
"fax_number": "703-330-2923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8640 SUDLEY RD STE 201",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201104404",
"telephone_number": "703-368-6819",
"fax_number": "703-330-2923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHURBERG",
"first_name": "JONATHAN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-17",
"last_updated": "2012-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "VA",
"license": "0101027526",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2277940001",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006065155",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM/MANASSAS",
"identifier": "071108",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "34542",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST",
"identifier": "92130001",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM/WARRENTON",
"identifier": "071112",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}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 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.