NPIMap

Organization Active NPI

Loudoun Medical Group, PC

  • Hematology & Oncology Physician
  • Leesburg, VA
National Provider Identifier
1093339764
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
LOUDOUN MEDICAL GROUP, PC
Practice address
19500 Sandridge Way Ste 400
Leesburg, VA 20176-3691
Phone
(703) 723-5700
NPI assigned
May 29, 2020
Organization subpart
Yes
Parent organization
LOUDOUN MEDICAL GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 18, 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
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

19500 Sandridge Way Ste 400
Leesburg, VA 20176-3691

Mailing address

224D Cornwall St NW Ste 403
Leesburg, VA 20176-2704
Phone (703) 737-6000

Other identifiers 1

IdentifierTypeStateIssuer
1675951440MedicaidVA

Other names 1

  • Skin Cancer Center of Northern Virginia Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Leesburg Health Information Exchange (HIE)

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 24

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

View all 24

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": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1093339764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224D CORNWALL ST NW STE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SANDRIDGE WAY STE 400",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763691",
            "telephone_number": "703-723-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUDOUN MEDICAL GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOUDOUN MEDICAL GROUP, PC",
        "enumeration_date": "2020-05-29",
        "last_updated": "2023-08-18",
        "certification_date": "2021-08-11",
        "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": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1675951440",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Leesburg",
            "affiliation": "N",
            "endpointDescription": "Leeburg",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "19500 Sandridge Way Ste 400",
            "city": "Leesburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201763691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Skin Cancer Center of Northern Virginia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Skin Cancer Center of Northern Virginia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.