Privia Medical Group

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

PRIVIA MEDICAL GROUP

Practice address

2010 Opitz Blvd Ste C
Woodbridge, VA 22191-3359

Phone

(703) 690-1152

NPI assigned

Sep 1, 2016

Last updated

Mar 5, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maureen Clancy

Title

Senior Vice President

Phone

(571) 366-8850

Specialties & licenses 1

Addresses

Other names 1

• Family Orthopaedics and Sports Medicine of Northern Virginia Other name

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1467908061",
    "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": "2010 OPITZ BLVD STE C",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913359",
            "telephone_number": "703-690-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVIA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "CLANCY",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "571-366-8850"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Orthopaedics and Sports Medicine of Northern Virginia",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Family Orthopaedics and Sports Medicine of Northern Virginia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Prince William Pediatrics and Adolescent Center
• Prince William Plastic Surgery and Spa Services Company, LLC (Michael P Gross, MD)
• Prince William Speech and Hearing Center, Inc
• Claria Lynna Prior
• Priority Medical Transport LLC
• Privia Medical Group, LLC
• Privia Medical Group, LLC
• Privia Medical Group, LLC (GoWell Urgent Care)
• Privia Medical Group, LLC (GoWell Urgent Care, LLC)
• PRN Medical Staffers

• Orthopaedic Surgery Physician in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Orthopaedic Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.