NPIMap

Organization Active NPI

Loudoun Medical Group, PC

Doing business as Physicians Premiere Weight and Wellness Center

  • Obesity Medicine (Family Medicine) Physician
  • Fairfax, VA
National Provider Identifier
1962369959
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X
Legal business name
LOUDOUN MEDICAL GROUP, PC
Doing business as
Physicians Premiere Weight and Wellness Center
Practice address
3700 Joseph Siewick Drive, Suite 106
Fairfax, VA 22033-1737
Phone
(571) 724-4400
NPI assigned
Jan 9, 2026
Last updated
Jan 28, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
LOUDOUN MEDICAL GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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) 737-6010

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Obesity Medicine (Family Medicine) Physician 207QB0002X Primary

Addresses

Primary practice location

3700 Joseph Siewick Drive, Suite 106
Fairfax, VA 22033-1737

Mailing address

224D Cornwall St NW Ste 403
Leesburg, VA 20176-2704
Phone (703) 737-6010

Other names 1

  • Physicians Premiere Weight and Wellness Center Doing business as

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
49D2339223Physicians Premiere Weight and Wellness Center3700 Joseph Siewick Drive, #106, Fairfax, VA 22033Certificate of waiverFeb 25, 2028

National Provider Directory

National Provider Directory
Tax ID family
Nova Medical Group305 organizations share this tax ID, including this one
Part of
Nova Medical Group

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

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": "1767916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1962369959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224D CORNWALL ST NW STE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DRIVE, SUITE 106",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331737",
            "telephone_number": "571-724-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUDOUN MEDICAL GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOUDOUN MEDICAL GROUP, PC",
        "enumeration_date": "2026-01-09",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "TAMASY",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-737-6010"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Premiere Weight and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.