John W. Brady, Jr., M.D. PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101019666 Issued in VA

Legal business name

JOHN W. BRADY, JR., M.D. PLLC

Practice address

8650 Sudley Road
Suite 310
Manassas, VA 20110-4416

Phone

(703) 369-3376

Fax

(703) 369-1118

NPI assigned

Jun 9, 2008

Organization subpart

Yes

Parent organization

JOHN W. BRADY, JR. M.D. PLLCAs reported in NPPES

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

Authorized official

Name

Dr. John William Brady Jr., MD

Title

Owner

Phone

(703) 369-3376

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

John W Brady Jr MD PLL

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225238400000",
    "number": "1982863569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8650 SUDLEY ROAD",
            "address_2": "SUITE 310",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104416",
            "telephone_number": "703-369-3376",
            "fax_number": "703-369-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8650 SUDLEY ROAD",
            "address_2": "SUITE 310",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104416",
            "telephone_number": "703-369-3376",
            "fax_number": "703-369-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN W. BRADY, JR., M.D. PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHN W. BRADY, JR. M.D. PLLC",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-10-29",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-369-3376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101019666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "C10547",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.