NPIMap

Organization Active NPI

Privia Medical Group, LLC

  • Internal Medicine Physician
  • Waldorf, MD
National Provider Identifier
1245169853
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRIVIA MEDICAL GROUP, LLC
Practice address
3460 Old Washington Rd Ste 203a
Waldorf, MD 20602-3243
Phone
(301) 638-9670
NPI assigned
May 18, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Authorized official

Name
Brianna Foulkrod
Title
Avp, Cred & Enrollment
Phone
(571) 650-2710

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

3460 Old Washington Rd Ste 203a
Waldorf, MD 20602-3243

Mailing address

950 N Glebe Rd Ste 700
Arlington, VA 22203-4173
Phone (800) 973-1442

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 24

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

View all 24

Locations

3460 Old Washington Rd
Ste 203A
Waldorf, MD 20602
Phone (240) 221-3116

NPI Registry JSON

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

{
    "created_epoch": "1779062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1245169853",
    "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",
            "telephone_number": "800-973-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 OLD WASHINGTON RD STE 203A",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023243",
            "telephone_number": "301-638-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVIA MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-18",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "FOULKROD",
        "authorized_official_first_name": "BRIANNA",
        "authorized_official_title_or_position": "AVP, CRED & ENROLLMENT",
        "authorized_official_telephone_number": "571-650-2710"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; 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.