Williamsburg Neurology, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101052740 Issued in VA

Legal business name

WILLIAMSBURG NEUROLOGY, P.C.

Practice address

120 Kings Way
Suite 2700
Williamsburg, VA 23185-2505

Phone

(757) 221-0110

Fax

(757) 221-0851

NPI assigned

Jul 6, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Shawn M. Brainard, MBA

Title

Medical Practice Administrator

Phone

(757) 345-3907

Specialties & licenses 2

Addresses

Other identifiers 9

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1831196872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 KINGS WAY",
            "address_2": "SUITE 2700",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852505",
            "telephone_number": "757-221-0110",
            "fax_number": "757-221-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 KINGS WAY",
            "address_2": "SUITE 2700",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852505",
            "telephone_number": "757-221-0110",
            "fax_number": "757-221-0851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSBURG NEUROLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-06",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "BRAINARD",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MEDICAL PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "757-345-3907",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101048000",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101052740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104215",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP NUMBER",
            "identifier": "270420",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARDING-ANTHEM BCBS",
            "identifier": "322877",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARDING-SOUTHERN HEALTH",
            "identifier": "84282",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUEIDAN-SOUTHERN HEALTH",
            "identifier": "95834",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6154085",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUEIDAN-ANTHEM BCBS",
            "identifier": "270421",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUEIDAN-SENTARA PROVIDER",
            "identifier": "45061",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARDING-SENTARA PROVIDERU",
            "identifier": "54560",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.