NPIMap

Organization Active NPI

Privia Medical Group, LLC

  • Pain Medicine Physician
  • Rockville, MD
National Provider Identifier
1023715315
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
PRIVIA MEDICAL GROUP, LLC
Practice address
121 Congressional LN Ste 403
Rockville, MD 20852-1542
Phone
(240) 630-2188
NPI assigned
Feb 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Authorized official

Name
Susan Porter
Title
Payer Enrollment Manager
Phone
(615) 500-2199

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

121 Congressional LN Ste 403
Rockville, MD 20852-1542

Mailing address

950 N Glebe Rd Ste 700
Arlington, VA 22203-4173

Other names 1

  • Neurology, Headache & Pain Institute Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Privia Medical Group LLC381 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1023715315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N GLEBE RD STE 700",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222034173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CONGRESSIONAL LN STE 403",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208521542",
            "telephone_number": "240-630-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVIA MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-08",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PAYER ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "615-500-2199"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neurology, Headache & Pain Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.