NPIMap

Organization Active NPI

Loudoun Medical Group, PC

Doing business as Urogynecology Center of Northern Virginia

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • Reston, VA
National Provider Identifier
1235664897
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianTaxonomy code 2088F0040X
Legal business name
LOUDOUN MEDICAL GROUP, PC
Doing business as
Urogynecology Center of Northern Virginia
Practice address
1860 Town Center Dr, Suite 140
Reston, VA 20190-5898
Phone
(703) 293-5239
Fax
(571) 526-4393
NPI assigned
Apr 20, 2017
Last updated
Apr 24, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
LOUDOUN MEDICAL GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 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
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician 2088F0040X NU Primary

Addresses

Primary practice location

1860 Town Center Dr, Suite 140
Reston, VA 20190-5898

Mailing address

224-D Cornwall Street, NW, Suite 403
Suite 403
Leesburg, VA 20176-2700
Phone (703) 737-6010

Other names 1

  • Urogynecology Center of Northern Virginia Doing business as

National Provider Directory

National Provider Directory
Tax ID family
John M Archer MD305 organizations share this tax ID, including this one
Part of
John M Archer 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": "1492646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1235664897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224-D CORNWALL STREET, NW, SUITE 403",
            "address_2": "SUITE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762700",
            "telephone_number": "703-737-6010",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 TOWN CENTER DR, SUITE 140",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905898",
            "telephone_number": "703-293-5239",
            "fax_number": "571-526-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUDOUN MEDICAL GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOUDOUN MEDICAL GROUP, PC",
        "enumeration_date": "2017-04-20",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "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": "2088F0040X",
            "taxonomy_group": "",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Urogynecology Center of Northern Virginia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Urogynecology Center of Northern Virginia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.