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NPI 1588941629 · Orthopaedic Surgery of the Spine Physician · Leesburg, VA
Provider details
- NPI number
- 1588941629
- Entity type
- Organization
- Primary specialty
- Orthopaedic Surgery of the Spine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ian Wattenmaker, Doctor(703) 777-1553
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
224d Cornwall St Nw
Suite 204
Leesburg, VA 20176-2700
Phone: (703) 777-1553
Fax: (703) 777-5524
Street-level locationGet directions
Mailing address
Po Box 17334
Baltimore, MD 21297-1334
Registry dates
- Enumerated
- 2011-11-03
- Last updated
- 2011-11-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.