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
1	225100000X	Physical Therapist
2	261QM1000X	Migrant Health Clinic/Center
3	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician

General Provider Information

NPI Number	:	1922959048
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	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11301 AMHERST AVE STE 102
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-4665
Country	:	US
Telephone Number	:	301-933-7827
Fax Number	:	240-290-0432

Authorized Official
Title or Position	:	AVP, CREDENTIALING & PAYER ENROLLME
Name	:	BRIANNA PEOPLES
Credential	:
Telephone Number	:	571-650-2710

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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