Individual provider Active NPI

Craig Cameron Brawley, MD

  • Facial Plastic Surgery Physician
  • Leesburg, VA
National Provider Identifier
1538663273
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
1010280100 Issued in VA
Practice address
540 Glade Fern Ter SE
Leesburg, VA 20175-5422
Phone
(571) 252-9237
Fax
(571) 200-9703
NPI assigned
Mar 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 125.072627 IL
Facial Plastic Surgery Physician 207YS0123X 1010280100 VA Primary

Addresses

Primary practice location

540 Glade Fern Ter SE
Leesburg, VA 20175-5422

Mailing address

19490 Sandridge Way Ste 70
Leesburg, VA 20176-3472
Phone (571) 252-9237

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

State licenses

LicenseStateTypeSpecialty
1010280100VAMDFacial Plastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1538663273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19490 SANDRIDGE WAY STE 70",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763472",
            "telephone_number": "571-252-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 GLADE FERN TER SE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201755422",
            "telephone_number": "571-252-9237",
            "fax_number": "571-200-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAWLEY",
        "first_name": "CRAIG",
        "middle_name": "CAMERON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "125.072627",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "VA",
            "license": "1010280100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.