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General NPI Number Information
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NPI Number | 1275484073
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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 | 02/06/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 1119 ROCKVILLE PIKE STE 500
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City | ROCKVILLE
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State | MD
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Zip | 20852-3157
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Country | US
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Telephone | 240-630-2188
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Fax | 301-603-2294
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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 AND ENROLLMENT
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Name | BRIANNA FOULKROD
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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