NPIMap

Organization Active NPI

Loudoun Medical Group, PC

Doing business as Metropolitan Immune

  • Clinical & Laboratory Immunology (Allergy & Immunology) Physician
  • Alexandria, VA
National Provider Identifier
1881356814
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical & Laboratory Immunology (Allergy & Immunology) PhysicianTaxonomy code 207KI0005X
Legal business name
LOUDOUN MEDICAL GROUP, PC
Doing business as
Metropolitan Immune
Practice address
6355 Walker Lane
Suite 308
Alexandria, VA 22310-3247
Phone
(703) 313-7700
Fax
(703) 313-0178
NPI assigned
Oct 7, 2021
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
Ceo
Phone
(703) 737-6001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical & Laboratory Immunology (Allergy & Immunology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207KI0005X Primary

Addresses

Primary practice location

6355 Walker Lane
Suite 308
Alexandria, VA 22310-3247

Mailing address

224D Cornwall Street NW
Suite 403
Leesburg, VA 20176-2704
Phone (703) 737-6001

Other names 1

  • Metropolitan Immune Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Loudoun Medical Group P305 organizations share this tax ID, including this one
Part of
Loudoun Medical Group P

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

6355 Walker Ln
Alexandria, VA 22310
Phone (703) 664-7453

6355 Walker Ln
Ste 308
Alexandria, VA 22310
Phone (703) 313-7700

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": "1633564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1881356814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224D CORNWALL STREET NW",
            "address_2": "SUITE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6001",
            "fax_number": "571-291-9786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 WALKER LANE",
            "address_2": "SUITE 308",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103247",
            "telephone_number": "703-313-7700",
            "fax_number": "703-313-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUDOUN MEDICAL GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOUDOUN MEDICAL GROUP, PC",
        "enumeration_date": "2021-10-07",
        "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": "CEO",
        "authorized_official_telephone_number": "703-737-6001"
    },
    "taxonomies": [
        {
            "code": "207KI0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metropolitan Immune",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Metropolitan Immune",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alexandria, 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.