Healthcare Provider Details
I. General information
NPI: 1851246722
Provider Name (Legal Business Name): PRIVIA MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/04/2026
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11119 ROCKVILLE PIKE STE 500
ROCKVILLE MD
20852-3157
US
IV. Provider business mailing address
950 N GLEBE RD STE 700
ARLINGTON VA
22203-4173
US
V. Phone/Fax
- Phone: 240-630-2188
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081N0008X |
| Taxonomy | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251N0400X |
| Taxonomy | Neurology Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIANNA
PEOPLES
Title or Position: AVP
Credential:
Phone: 571-650-2710