NPIMap

Organization Active NPI

Privia Medical Group, LLC

  • Family Medicine Physician
  • Waldorf, MD
National Provider Identifier
1891557476
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIVIA MEDICAL GROUP, LLC
Practice address
12070 Old Line Ctr Ste 302
Waldorf, MD 20602-2567
Phone
(301) 843-7667
NPI assigned
Jan 29, 2024
Last updated
Jul 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Authorized official

Name
Brianna Foulkrod
Title
Avp
Phone
(571) 650-2710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

12070 Old Line Ctr Ste 302
Waldorf, MD 20602-2567

Mailing address

950 N Glebe Rd Ste 700
Arlington, VA 22203-4173
Phone (484) 569-9066

National Provider Directory

National Provider Directory
Tax ID family
Priva Med GRP LLC385 organizations share this tax ID, including this one

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

NPI Registry JSON

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1891557476",
    "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",
            "telephone_number": "484-569-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR STE 302",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022567",
            "telephone_number": "301-843-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVIA MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A",
        "authorized_official_last_name": "FOULKROD",
        "authorized_official_first_name": "BRIANNA",
        "authorized_official_title_or_position": "AVP",
        "authorized_official_telephone_number": "571-650-2710"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.