Douglas Spencer Brudno, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

0101231080 Issued in VA

Practice address

3300 Gallows Rd
Falls Church, VA 22042-3307

Phone

(703) 289-1400

Fax

(703) 289-1414

NPI assigned

May 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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 Neonatal Associates, PC

  • Pediatric Pulmonology Physician
  • Fairfax, VA
  • NPI 1538362504
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447207253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730-B PROSPERITY A VENUE",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312238",
            "telephone_number": "703-289-1400",
            "fax_number": "703-289-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-289-1400",
            "fax_number": "703-289-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUDNO",
        "first_name": "DOUGLAS",
        "middle_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "VA",
            "license": "0101231080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6718167",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6719996",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6720093",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anson Cody Brown, PA-C
• Emily Margaret Brown, LMFT
• Megan Alexandra Brown, NP
• Susan P Brown, M.D.
• Timeshay Brown, FNP
• Christina Anna Maria Bruno, MD
• Brusco Vision LLC
• Michael Anthony Brusco, M.D.
• Laurie Brutus, RN, IBCLC
• Reed Harrison Bryant

• All providers in Falls Church, VA
• Neonatal-Perinatal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.