Individual provider Active NPI

Laurel Imhoff Braverman, AU.D.

  • Audiologist
  • Manassas, VA
National Provider Identifier
1790995702
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201001448 Issued in VA
Practice address
8703 Stonewall Rd
Suite 1B
Manassas, VA 20110-8325
Phone
(703) 369-3500
NPI assigned
May 22, 2007
Last updated
Mar 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2201001448 VA Primary

Addresses

Primary practice location

8703 Stonewall Rd
Suite 1B
Manassas, VA 20110-8325

Mailing address

8703 Stonewall Rd
Suite 1B
Manassas, VA 20110-8325
Phone (703) 369-3500

Other names 1

  • Laurel E. Imhoff Former name

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
002184NYMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Audiology & Speech Associates, Inc. Audiologist PastSince Jan 1, 2000 Accepting new patients
Audigycare, LLC PastSince Jul 1, 2013 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1790995702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8703 STONEWALL RD",
            "address_2": "SUITE 1B",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108325",
            "telephone_number": "703-369-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8703 STONEWALL RD",
            "address_2": "SUITE 1B",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108325",
            "telephone_number": "703-369-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVERMAN",
        "first_name": "LAUREL",
        "middle_name": "IMHOFF",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREL",
            "last_name": "IMHOFF",
            "middle_name": "E.",
            "credential": "AU.D.",
            "code": "1",
            "type": "Former 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 Mar 1, 2016; 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.