Lake Manassas Medical Psychiatry

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0101233772 Issued in VA

Legal business name

LAKE MANASSAS MEDICAL PSYCHIATRY

Practice address

7544 Gardner Park Dr
Gainesville, VA 20155-3414

Phone

(703) 772-7400

Fax

(703) 940-9179

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Craig Charles Krause, MD

Title

Sole Member

Phone

(703) 772-7400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1588722425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7544 GARDNER PARK DR",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553414",
            "telephone_number": "703-772-7400",
            "fax_number": "703-940-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7544 GARDNER PARK DR",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553414",
            "telephone_number": "703-772-7400",
            "fax_number": "703-940-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MANASSAS MEDICAL PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRAUSE",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "703-772-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101233772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisan G Kula, M.D.
• Soonyou Kwon, MD
• Jessica La, FNP
• Trang T Lai, DC
• Lake Manassa Dental Center
• Lake Manassas SNF LLC
• Meghna Lama, MD
• Laurel H. Lan, PA
• Sharron Ruth Land
• Alyssa M Lane, NCC, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.