NPIMap

Organization Active NPI

Privia Medical Group, LLC

  • Cardiovascular Disease Physician
  • Waldorf, MD
National Provider Identifier
1457113441
Registry record updated Apr 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
PRIVIA MEDICAL GROUP, LLC
Practice address
11340 Pembrooke SQ Ste 213
Waldorf, MD 20603-4808
Phone
(202) 832-1800
NPI assigned
Jan 25, 2024
Last updated
Apr 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 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 and Enrollment
Phone
(571) 650-2710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

11340 Pembrooke SQ Ste 213
Waldorf, MD 20603-4808

Mailing address

950 N Glebe Rd Ste 700
Arlington, VA 22203-4173
Phone (571) 982-6636

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

11340 Pembrooke Sq
Ste 213
Waldorf, MD 20603
Phone (301) 645-8320

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776470400000",
    "number": "1457113441",
    "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": "571-982-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11340 PEMBROOKE SQ STE 213",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034808",
            "telephone_number": "202-832-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVIA MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-25",
        "last_updated": "2026-04-18",
        "certification_date": "2026-04-18",
        "status": "A",
        "authorized_official_last_name": "FOULKROD",
        "authorized_official_first_name": "BRIANNA",
        "authorized_official_title_or_position": "AVP CRED AND ENROLLMENT",
        "authorized_official_telephone_number": "571-650-2710"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Apr 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.