Privia Medical Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PRIVIA MEDICAL GROUP, LLC

Practice address

9401 Lee Hwy
Suite 400
Fairfax, VA 22031-1849

Phone

(703) 383-4836

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 2

Addresses

Other names 1

• Virginia Family Medicine 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": "1467909036",
    "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": "9401 LEE HWY",
            "address_2": "SUITE 400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220311849",
            "telephone_number": "703-383-4836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVIA MEDICAL GROUP, LLC",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virginia Family Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Virginia Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Andrew Anthony Prishack, PT
• Dannah Pritchard
• Privia Medical Group, LLC
• Privia Medical Group, LLC
• Privia Medical Group, LLC
• Privia Medical Group, LLC
• Privia Medical Group, LLC
• Privia Medical Group, LLC
• Priya Gupta DDS PC
• Pro Healthcare Servicing, LLC

• Family Medicine Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Family Medicine 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.