LOUDOUN MEDICAL GROUP PC (NPI# 1811351166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811351166 |
| Entity Type | Organization |
| Organization Name | LOUDOUN MEDICAL GROUP PC |
| Other Organization Name | UROGYNECOLOGY CENTER OF NORTHERN VIRGINIA |
| Practice Address |
1830 Town Center Dr Suite 306 Reston VA 20190-3292 |
| Mailing Address |
Po Box 17334 Baltimore MD 21297-1334 |
| Practice Telephone | 7032935239 |
| Mailing Telephone | 7034436717 |
| Mailing Fax Number | 7034438643 |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2016-04-12 |
| Authorized Official Name | MARY BETH TAMASY (CEO) |
| Authorized Official Telephone | 7037376010 |
| Is Organization Subpart | Y |
| Parent Organization Name | LOUDOUN MEDICAL GROUP PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2088F0040X |
Urology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Urogynecology Center of Northern Virginia | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891217857 | Loudoun Medical Group PC | Obstetrics & Gynecology | 3301 Woodburn Rd Ste 309, Annandale, VA 22003-7308 | 2017-07-12 |
| 1487107587 | Loudoun Medical Group PC | Specialist | 6355 Walker Ln Ste 303, Suite 303, Alexandria, VA 22310-3247 | 2016-07-26 |
| 1184077976 | Loudoun Medical Group PC | Ophthalmology | 1901 N Beauregard St, Suite 100, Alexandria, VA 22311-1738 | 2016-07-18 |
| 1659728889 | Loudoun Medical Group PC | Urology | 24430 Stone Springs Blvd, Suite 100, Dulles, VA 20166-2247 | 2016-05-18 |
| 1285093070 | Loudoun Medical Group PC | Obstetrics & Gynecology | 8292 Old Courthouse Rd, Suite C, Vienna, VA 22182-3834 | 2016-02-22 |
| 1841658499 | Loudoun Medical Group PC | Internal Medicine | 10200 Colvin Run Rd, Suite 326, Great Falls, VA 22066-1830 | 2016-02-10 |
| 1114303922 | Loudoun Medical Group PC | Surgery | 19415 Deerfield Ave Ste 213, Lansdowne, VA 20176-8471 | 2015-08-04 |
| 1285021345 | Loudoun Medical Group PC | Ophthalmology | 8751 Sudley Rd, 2nd Floor, Manassas, VA 20110-8319 | 2015-04-16 |
| 1821409590 | Loudoun Medical Group PC | Internal Medicine | 3687 Fettler Park Dr, Dumfries, VA 22025-2049 | 2014-05-15 |
| 1134530900 | Loudoun Medical Group PC | Internal Medicine | 4897 Prince William Pkwy, Suite C 102, Woodbridge, VA 22192-5432 | 2014-05-15 |
| Street Address |
1830 TOWN CENTER DR SUITE 306 |
| City | RESTON |
| State | VA |
| Zip Code | 20190-3292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427032564 | Richard L Stokes IIi | Specialist | 1830 Town Center Dr, Suite 207, Reston, VA 20190-3292 | 2005-12-02 |
| 1306211370 | Urology Center-usa Inc | Specialist | 1830 Town Center Dr, Suite 301, Reston, VA 20190-3292 | 2015-12-02 |
| 1164787065 | Aishah Carol Hassan | Voluntary or Charitable | 1830 Town Center Dr, Reston, VA 20190-3292 | 2012-07-07 |
| 1063739324 | Healthy Heart Sleep Center, LLC | Clinical Medical Laboratory | 1830 Town Center Dr, Suite 405, Reston, VA 20190-3292 | 2010-04-27 |
| 1578729216 | Tae Joon Chung, Md PC | Internal Medicine | 1830 Town Center Dr, Suite 308, Reston, VA 20190-3292 | 2008-08-01 |
| 1316110125 | Richard Lee Cho | Psychiatry & Neurology | 1830 Town Center Dr, Suite 305, Reston, VA 20190-3292 | 2008-04-12 |
| 1730364969 | Rabih Kanan Hamzeh | Specialist | 1830 Town Center Dr, Suite #303, Reston, VA 20190-3292 | 2008-01-07 |
| 1710160205 | M Karim Ali Md Facs PC | Otolaryngology | 1830 Town Center Dr, Suite 209, Reston, VA 20190-3236 | 2007-12-07 |
| 1689855587 | David K Chow, Md, PC | Ophthalmology | 1830 Town Center Dr, Suite 210, Reston, VA 20190-3292 | 2007-11-19 |
| 1841494796 | Pediatric Physicians of Reston, PC | Pediatrics | 1830 Town Center Dr, Suite # 205, Reston, VA 20190-3292 | 2007-06-13 |
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|---|---|---|---|---|
| 1912548470 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1906 Reston Metro Plaza, Suite 100, Reston, VA 20190 | 2019-10-04 |
| 1205483260 | Northern Virginia Applied Behavior Analysis, L.L.C. | Behavioral Analyst | 1984 Issac Newton Square West, Suite 204, Reston, VA 20190 | 2019-08-23 |
| 1336796481 | Sandra Chiunda | Nurse Practitioner | 11484 Washington Plaza W 3rd Floor, Reston, VA 20190 | 2019-08-23 |
| 1891357232 | Beyond Counseling, Inc. | Clinic/Center | 11250 Roger Bacon Dr., Atrium 5, Reston, VA 20190 | 2019-07-06 |
| 1003470063 | Sarah Katharina Jungnitsch | Registered Nurse | Reston Anesthesia Associates, 11341 Sunset Hills Road, Reston, VA 20190 | 2019-04-25 |
| 1194202341 | May Health Care Services Inc | Home Health | 12110 Sunset Hills Road Suite 600, Reston, VA 20190 | 2018-07-20 |
| 1245739895 | Carlee B. Genung | Physician Assistant | 1760 Reston Parkway Suite 306, Reston, VA 20190 | 2018-02-09 |
| 1760901045 | Kristen Kelly | Dietitian, Registered | 11703 Bowman Green Drive, Lower Level, Reston, VA 20190 | 2017-09-18 |
| 1245778992 | Sarah Christine Bernstein | Occupational Therapist | 1860 Town Center Drive Ste, Suite 300, Reston, VA 20190 | 2017-02-02 |
| 1023495298 | Phillip Nguyen | Dentist | 1800 Town Center Dr Ste 116, Reston, VA 20190 | 2015-04-27 |
| Find all providers in zip 20190 | ||||
| Taxonomy Code | 2088F0040X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Female Pelvic Medicine and Reconstructive Surgery |
| A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. |
| Notes: Source: American Board of Medical Specialties, 2011. [1/1/2012: new] Resources: www.abms.org |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235664897 | Loudoun Medical Group, P.C. | Urology | 1860 Town Center Dr, Suite 140, Reston, VA 20190-5896 | 2017-04-20 |
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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.