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General NPI Number Information
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NPI Number | 1205787322
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Entity Type | Organization
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Legal Business Name | PRIVIA MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 104 E BROAD ST STE A
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City | FALLS CHURCH
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State | VA
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Zip | 22046-4501
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Country | US
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Telephone | 703-237-1555
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Fax | 703-237-2253
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Provider Business Mailing Address
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Address Line | 950 N GLEBE RD STE 700
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City | ARLINGTON
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State | VA
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Zip | 22203-4173
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AVP, CREDENTIALING & PAYER ENROLLME
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Name | BRIANNA PEOPLES
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Credential |
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Telephone | 571-650-2710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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