NPIMap

Organization Active NPI

Prince William Urology Associates LTD

  • Specialist
  • Manassas, VA
National Provider Identifier
1639229818
Registry record updated Jan 25, 2019
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Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PRINCE WILLIAM UROLOGY ASSOCIATES LTD
Practice address
8525 Rolling Rd Ste 220
Manassas, VA 20110-3648
Phone
(703) 393-0700
Fax
(703) 393-0661
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2019

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

Authorized official

Name
Mrs. Dana L Oakley
Title
Credentialing Coordinator
Phone
(703) 393-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

8525 Rolling Rd Ste 220
Manassas, VA 20110-3648

Mailing address

8525 Rolling Rd Ste 220
Manassas, VA 20110-3648
Phone (703) 393-0700

Other identifiers 3

IdentifierTypeStateIssuer
010198976MedicaidVA
1427151612MedicaidVA
007510306MedicaidVA

Other names 1

  • Drs Gil Montero & Sehn Ltd Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548374400000",
    "number": "1639229818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8525 ROLLING RD STE 220",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201103648",
            "telephone_number": "703-393-0700",
            "fax_number": "703-393-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8525 ROLLING RD STE 220",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201103648",
            "telephone_number": "703-393-0700",
            "fax_number": "703-393-0661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCE WILLIAM UROLOGY ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2019-01-25",
        "status": "A",
        "authorized_official_last_name": "OAKLEY",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "703-393-0700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010198976",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427151612",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007510306",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs Gil Montero & Sehn Ltd",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Drs Gil Montero & Sehn Ltd",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jan 25, 2019; 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.