PRIVIA MEDICAL GROUP, LLC (NPI# 1316598758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316598758 |
| Entity Type | Organization |
| Organization Name | PRIVIA MEDICAL GROUP, LLC |
| Other Organization Name | MOUNT VERNON INTERNAL MEDICINE |
| Practice Address |
8109 Hinson Farm Rd Ste 504 Alexandria VA 22306-3411 |
| Mailing Address |
950 N Glebe Rd Ste 700 Arlington VA 22203-4173 |
| Practice Telephone | 5713668850 |
| Mailing Telephone | 5713668850 |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2020-03-05 |
| Authorized Official Name | COURTNEY AINSWORTH IVESS (ASSOCIATE DIRECTOR, CREDENTIALING) |
| Authorized Official Telephone | 5713668831 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE NSC | 7442750008 | 01 |
| Other Name | Type Code |
|---|---|
| Mount Vernon Internal Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154961316 | Privia Medical Group, LLC | Internal Medicine | 24560 Southpoint Dr Ste 200, Aldie, VA 20105-3505 | 2020-01-15 |
| 1558919134 | Privia Medical Group, LLC | Clinic/Center | 104a E Broad St Ste A, Falls Church, VA 22046-4501 | 2019-08-28 |
| 1013042480 | Privia Medical Group, LLC | Pediatrics | 950 N Glebe Rd, Suite 4000, Arlington, VA 22203-1824 | 2007-02-23 |
| 1861099541 | Privia Medical Group, LLC | Family Medicine | 14300 Gallant Fox Ln Ste 222, Bowie, MD 20715-4033 | 2020-10-06 |
| 1962053306 | Privia Medical Group, LLC | Podiatrist | 8988 Lorton Station Blvd Ste 100, Lorton, VA 22079-4757 | 2019-09-26 |
| 1225689698 | Privia Medical Group, LLC | Podiatrist | 6128 Brandon Ave Ste 201, Springfield, VA 22150-2693 | 2019-09-26 |
| 1093251209 | Privia Medical Group, LLC | Family Medicine | 950 N Glebe Rd, Suite 4000, Arlington, VA 22203-1824 | 2017-01-11 |
| 1881138261 | Privia Medical Group, LLC | Internal Medicine | 1616 Forest Dr, Suite 1, Annapolis, MD 21403-1019 | 2016-12-05 |
| 1265975924 | Privia Medical Group, LLC | Internal Medicine | 7625 Wisconsin Ave, Suite 101, Bethesda, MD 20814-6512 | 2016-11-29 |
| 1487105946 | Privia Medical Group, LLC | Podiatrist | 1201 Seven Locks Rd, Suite 202, Rockville, MD 20854-2931 | 2016-10-20 |
| Street Address |
8109 HINSON FARM RD STE 504 |
| City | ALEXANDRIA |
| State | VA |
| Zip Code | 22306-3411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720038862 | Kathleen Elizabeth Mares | Nurse Practitioner | 8109 Hinson Farm Rd Ste 504, Alexandria, VA 22306-3411 | 2006-05-11 |
| 1750938684 | Rebecca Johnson | Registered Nurse | 8109 Hinson Farm Rd Ste 504, Alexandria, VA 22306-3411 | 2019-08-26 |
| 1336626142 | Lexi Vick | Nurse Practitioner | 8109 Hinson Farm Rd Ste 504, Alexandria, VA 22306-3411 | 2018-07-24 |
| 1194242610 | Melissa Hewitt | Nurse Practitioner | 8109 Hinson Farm Rd Ste 504, Alexandria, VA 22306-3411 | 2017-08-25 |
| 1215382940 | Sarah Dennemeyer | Family Medicine | 8109 Hinson Farm Rd Ste 504, Alexandria, VA 22306-3411 | 2016-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003450412 | Felicia Aboagye | Registered Nurse | Gartlan Center, 8119 Holland Road, Alexandria, VA 22306 | 2019-10-30 |
| 1306490727 | Quality Care Services LLC | Home Health | 6969 Richmond Highway, Suite 203, Alexandria, VA 22306 | 2019-07-25 |
| 1902388325 | James Mompoint | Behavioral Analyst | 3400 State St Suite G750, Salem, OR 22306 | 2018-09-01 |
| 1821507062 | Jennifer Lewis | Physical Therapist | 6856 Richmond Highway, Alexandria, VA 22306 | 2017-09-20 |
| 1477094860 | Kwabena Bonsu Owusu-boateng | Family Medicine | 8109 Tis Well Drive, Suite 511, Alexandria, VA 22306 | 2017-03-17 |
| 1164881397 | Luke Maxwell Dillon | Family Medicine | Calle Padre Ugarte #3260, Otay, BAJA CALIFORNIA 22306 | 2016-02-16 |
| 1063892743 | Bridgitte Matthews | Physical Therapist | 6856 Richmond Hwy, Alexandria, VA 22306 | 2015-06-08 |
| 1114362076 | Costco Wholesale Corporation | Pharmacy | 7940 Richmond Hwy, Alexandria, VA 22306 | 2013-05-06 |
| 1689919847 | Kings Crossing Optometry, LLC | Optometrist | 6307-d Richmond Highway, Alexandria, VA 22306 | 2012-11-29 |
| 1730423856 | Patient First Richmond Medical Group Pllc | Family Medicine | 6311 Richmond Highway, Alexandria, VA 22306 | 2012-11-15 |
| Find all providers in zip 22306 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588277396 | Amm Consulting Inc | Internal Medicine | 6123 Stegen Dr, Alexandria, VA 22310-2277 | 2020-08-31 |
| 1750814109 | Ajita Acharya | Internal Medicine | 1800 N Beauregard St Ste 100, Alexandria, VA 22311-1726 | 2017-04-04 |
| 1689121709 | Mid Atlantic Medical Management, LLC | Internal Medicine | 5904 Old Richmond Highway, Suite 515, Alexandria, VA 22303 | 2016-09-07 |
| 1447649462 | Metro Medical Services, LLC | Internal Medicine | 6179 Grovedale Ct Ste 100, Alexandria, VA 22310-2553 | 2015-01-14 |
| 1225438385 | Globa'll Primary Care & Internal Medicine, P.C. | Internal Medicine | 50 Pickett Street, Suite 221, Alexandria, VA 22304-4708 | 2014-08-26 |
| 1982014171 | Sara Wasim | Internal Medicine | 1600 N Beauregard St Ste 300, Alexandria, VA 22311-1732 | 2014-04-28 |
| 1811239627 | Capital Healthcare PC | Internal Medicine | 6020 Richmond Hwy Ste 102, Alexandria, VA 22303-2157 | 2013-03-19 |
| 1558624619 | Yonis B Geberemariam | Internal Medicine | 5375 Duke St Apt 1103, Alexandria, VA 22304-3018 | 2012-06-22 |
| 1639439334 | Sharmila P Dhulipalla | Internal Medicine | 100 S Van Dorn St, Apt C-219, Alexandria, VA 22304-4341 | 2012-05-29 |
| 1821377458 | Werksew Tesfaye Turi | Internal Medicine | 750 Port St Apt 706, Alexandria, VA 22314-2485 | 2011-08-14 |
| Find all providers in ALEXANDRIA | ||||
| City | ALEXANDRIA |
| Zip Code | 22306 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.