NPIMap

Organization Active NPI

Loudoun Medical Group, PC

Doing business as Virginia Center for Neurosciences

  • Neurology Physician
  • Leesburg, VA
National Provider Identifier
1790053171
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
LOUDOUN MEDICAL GROUP, PC
Doing business as
Virginia Center for Neurosciences
Practice address
19450 Deerfield Ave
Suite 175
Leesburg, VA 20176-6820
Phone
(703) 858-5454
Fax
(703) 858-4650
NPI assigned
Dec 13, 2011
Last updated
Aug 18, 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 Aug 18, 2023

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

Authorized official

Name
Mary Beth Tamasy
Title
Credentialing Coordinator
Phone
(703) 737-6010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

19450 Deerfield Ave
Suite 175
Leesburg, VA 20176-6820

Mailing address

PO Box 17334
Baltimore, MD 21297-1334
Phone (703) 443-6717

Other names 1

  • Virginia Center for Neurosciences 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

Locations

19450 Deerfield Ave
Ste 175
Leesburg, VA 20176
Phone (703) 858-5454

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": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1790053171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17334",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212971334",
            "telephone_number": "703-443-6717",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19450 DEERFIELD AVE",
            "address_2": "SUITE 175",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201766820",
            "telephone_number": "703-858-5454",
            "fax_number": "703-858-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUDOUN MEDICAL GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOUDOUN MEDICAL GROUP, PC",
        "enumeration_date": "2011-12-13",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "TAMASY",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "703-737-6010"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virginia Center for Neurosciences",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Virginia Center for Neurosciences",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesburg, VA

Sources for this page

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