MEDICARE: PRIVIA MEDICAL GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1639023898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIVIA MEDICAL GROUP, LLC

Provider Business Mailing Address
First Line	:	950 N GLEBE RD STE 700
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22203-4173
Country	:	US
Telephone Number	:	800-973-1442
Fax Number	:

Provider Business Practice Location Address
First Line	:	7655 LEESBURG PIKE
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22043-2595
Country	:	US
Telephone Number	:	703-642-7522
Fax Number	:

Authorized Official
Title or Position	:	ENROLLMENT SPECIALIST
Name	:	REBECCA INOA
Credential	:
Telephone Number	:	800-973-1442

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	02/24/2026

Similar Medicare Providers

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1962212548 — MICHELLE PANOZO-NAULS PA-C
Practice Location Address:

7655 LEESBURG PIKE
FALLS CHURCH, VA
22043-2595

Practice Phone: 571-786-1492
Practice Fax:

1699634246 — KATHERINE JEANNE MCDONALD
Practice Location Address:

7655 LEESBURG PIKE
FALLS CHURCH, VA
22043-2595

Practice Phone: 703-642-7522
Practice Fax:

1629923438 — PRIVIA MEDICAL GROUP, LLC
Practice Location Address:

7655 LEESBURG PIKE
FALLS CHURCH, VA
22043-2595

Practice Phone: 571-786-1492
Practice Fax:

1760514780 — IDAHO PROSTHETICS & ORTHOTICS, INC.
Practice Location Address:

2595 CHANNING WAY
IDAHO FALLS, ID
83404-7516

Practice Phone: 208-523-9000
Practice Fax: 208-523-9039

1003692302 — MELISSA ODONNELL
Practice Location Address:

1314 CHURCH ST
REDLANDS, CA
92374-2595

Practice Phone: 310-482-1820
Practice Fax:

Directions to “PRIVIA MEDICAL GROUP, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.