NPIMap

Organization Active NPI

Loudoun Endoscopy Group, LLC

  • Endoscopy Clinic/Center
  • Lansdowne, VA
National Provider Identifier
1801962741
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
Legal business name
LOUDOUN ENDOSCOPY GROUP, LLC
Practice address
19455 Deerfield Ave Ste 212
Lansdowne, VA 20176-8102
Phone
(703) 724-9792
Fax
(703) 858-7310
NPI assigned
Nov 24, 2006
Last updated
Feb 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Authorized official

Name
Kristina Materna
Title
Director, Credentialing
Phone
(901) 377-8219

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X Primary

Addresses

Primary practice location

19455 Deerfield Ave Ste 212
Lansdowne, VA 20176-8102

Mailing address

One Gi Credentialing Department
PO Box 381468
Germantown, TN 38183-1468

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D1053463Loudoun Endoscopy Group, LLC19455 Deerfield Avenue Ste #212, Leesburg, VA 20176Certificate of waiverApr 24, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770076800000",
    "number": "1801962741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE GI CREDENTIALING DEPARTMENT",
            "address_2": "PO BOX 381468",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381831468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19455 DEERFIELD AVE STE 212",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201768102",
            "telephone_number": "703-724-9792",
            "fax_number": "703-858-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUDOUN ENDOSCOPY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A",
        "authorized_official_last_name": "MATERNA",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "DIRECTOR, CREDENTIALING",
        "authorized_official_telephone_number": "901-377-8219"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdowne, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.