NPIMap

Organization Active NPI

Loudoun Medical Group, PC

  • Pediatrics Physician
  • Chantilly, VA
National Provider Identifier
1003276783
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
LOUDOUN MEDICAL GROUP, PC
Practice address
24805 Pinebrook Road, Suite 109
Chantilly, VA 20152-4127
Phone
(703) 729-7652
Fax
(703) 729-8746
NPI assigned
Feb 24, 2016
Organization subpart
Yes
Parent organization
LOUDOUN MEDICAL GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Authorized official

Name
Mary Beth Tamasy
Title
Ceo
Phone
(703) 737-6010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

24805 Pinebrook Road, Suite 109
Chantilly, VA 20152-4127

Mailing address

224D Cornwall Street, NW, Ste 403
Leesburg, VA 20176-2704
Phone (703) 737-6010

Other names 1

  • Ashburn Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2118029Ashburn Pediatrics24805 Pinebrook Rd Suite 109, Chantilly, VA 20152Certificate of waiverAug 28, 2026

National Provider Directory

National Provider Directory
Tax ID family
Walter M Obrien MD305 organizations share this tax ID, including this one
Part of
Walter M Obrien MD

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

24805 Pinebrook Rd
Ste 109
Chantilly, VA 20152
Phone (571) 707-2067

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EGIADA

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1003276783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224D CORNWALL STREET, NW, STE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010",
            "fax_number": "571-291-9786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24805 PINEBROOK ROAD, SUITE 109",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201524127",
            "telephone_number": "703-729-7652",
            "fax_number": "703-729-8746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUDOUN MEDICAL GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOUDOUN MEDICAL GROUP, PC",
        "enumeration_date": "2016-02-24",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "TAMASY",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-737-6010"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ashburn Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ashburn Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.