LOUDOUN MEDICAL GROUP PC (NPI# 1144543018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144543018 |
| Entity Type | Organization |
| Organization Name | LOUDOUN MEDICAL GROUP PC |
| Other Organization Name | NORTHERN VIRGINIA ENT ASSOCIATES |
| Practice Address |
14631 Lee Hwy Suite 405 Centreville VA 20121-5824 |
| Mailing Address |
Po Box 17334 Baltimore MD 21297-1334 |
| Practice Telephone | 7034833610 |
| Practice Fax Number | 7034833616 |
| Mailing Telephone | 7034436717 |
| Mailing Fax Number | 7034438643 |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2010-03-08 |
| Authorized Official Name | JAMES A LAPSLEY (CEO) |
| Authorized Official Telephone | 7037376010 |
| Is Organization Subpart | Y |
| Parent Organization Name | LOUDOUN MEDICAL GROUP PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Northern Virginia ENT Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891217857 | Loudoun Medical Group PC | Obstetrics & Gynecology | 3301 Woodburn Rd Ste 309, Annandale, VA 22003-7308 | 2017-07-12 |
| 1487107587 | Loudoun Medical Group PC | Specialist | 6355 Walker Ln Ste 303, Suite 303, Alexandria, VA 22310-3247 | 2016-07-26 |
| 1184077976 | Loudoun Medical Group PC | Ophthalmology | 1901 N Beauregard St, Suite 100, Alexandria, VA 22311-1738 | 2016-07-18 |
| 1659728889 | Loudoun Medical Group PC | Urology | 24430 Stone Springs Blvd, Suite 100, Dulles, VA 20166-2247 | 2016-05-18 |
| 1285093070 | Loudoun Medical Group PC | Obstetrics & Gynecology | 8292 Old Courthouse Rd, Suite C, Vienna, VA 22182-3834 | 2016-02-22 |
| 1841658499 | Loudoun Medical Group PC | Internal Medicine | 10200 Colvin Run Rd, Suite 326, Great Falls, VA 22066-1830 | 2016-02-10 |
| 1114303922 | Loudoun Medical Group PC | Surgery | 19415 Deerfield Ave Ste 213, Lansdowne, VA 20176-8471 | 2015-08-04 |
| 1285021345 | Loudoun Medical Group PC | Ophthalmology | 8751 Sudley Rd, 2nd Floor, Manassas, VA 20110-8319 | 2015-04-16 |
| 1821409590 | Loudoun Medical Group PC | Internal Medicine | 3687 Fettler Park Dr, Dumfries, VA 22025-2049 | 2014-05-15 |
| 1134530900 | Loudoun Medical Group PC | Internal Medicine | 4897 Prince William Pkwy, Suite C 102, Woodbridge, VA 22192-5432 | 2014-05-15 |
| Street Address |
14631 LEE HWY SUITE 405 |
| City | CENTREVILLE |
| State | VA |
| Zip Code | 20121-5824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669449435 | Kanwal S Khan | Obstetrics & Gynecology | 14631 Lee Hwy, Suite 405, Centreville, VA 20121-5824 | 2006-03-01 |
| 1336697051 | All Female Ob/gyn | Clinic/Center | 14631 Lee Hwy, #405, Centreville, VA 20121-5824 | 2016-09-12 |
| 1093166308 | Teresa Cralle | Registered Nurse | 14631 Lee Hwy, #413, Centreville, VA 20121-5824 | 2016-06-28 |
| 1255682654 | Center for Specialty Care, Plc | Physical Therapist | 14631 Lee Hwy, Suite 310, Centreville, VA 20121-5824 | 2012-09-25 |
| 1730465154 | Mohamad Bashar Ayass | Dentist | 14631 Lee Hwy, #301, Centreville, VA 20121 | 2011-10-31 |
| 1366735235 | V Care Dental | Dentist | 14631 Lee Hwy, 117, Centreville, VA 20121-5824 | 2011-05-25 |
| 1710288840 | Kelly Smith | Physical Therapist | 14631 Lee Hwy, Suite 310, Centreville, VA 20121-5824 | 2010-11-05 |
| 1972774024 | Ira Clifford Newman | Psychiatry & Neurology | 14631 Lee Hwy, Suite #207, Centreville, VA 20121-5824 | 2008-03-17 |
| 1043413008 | Carol Govoni | Physical Therapist | 14631 Lee Hwy, Suite 310, Centreville, VA 20121-2112 | 2007-06-07 |
| 1558564526 | Centreville Physical Therapy, PC | Clinic/Center | 14631 Lee Hwy, Suite 310, Centreville, VA 20121-2112 | 2007-06-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356906994 | Everyone Inc. | Durable Medical Equipment & Medical Supplies | 6362 James Harris Way, Centreville, VA 20121 | 2019-05-09 |
| 1154845139 | Dien Tu | Pharmacist | 6321 Powder Flask Ct., Centreville, VA 20121 | 2017-08-01 |
| 1053865337 | Chungkang Pharmacy, LLC | Pharmacy | 14637 Lee Highway, #109b, Centreville, VA 20121 | 2016-08-04 |
| 1265829808 | Trisha Yamamoto | Chiropractor | 14215 E. Centreville Square, Centreville, VA 20121 | 2015-04-21 |
| 1811305733 | Catherine Elizabeth Sims, LLC | Clinic/Center | 6705 Bay Valley Lane, Centreville, VA 20121 | 2014-07-23 |
| 1194138438 | All In A Day Senior Care Services.com | Home Health | 6913 Confederate Ridge Lane, Centerville, VA 20121 | 2014-06-04 |
| 1447519483 | James Hamilton | Occupational Therapy Assistant | 6220 William Mosby Dr, Centreville, VA 20121 | 2012-05-11 |
| 1609158674 | Rena Thuman | Dentist | 14245-f Centreville Square, Centreville, VA 20121 | 2011-09-15 |
| 1134426372 | One Stop Pharmacy Inc | Pharmacy | 13818-b Braddock Rd, Centreville, VA 20121 | 2011-02-24 |
| 1225267495 | Michael Andrew Hartman | Family Medicine | 6201 Centerville Rd, # 100, Centreville, VA 20121 | 2009-07-09 |
| Find all providers in zip 20121 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629238597 | Loudoun Medical Group PC | Otolaryngology | 5895 Trinity Pkwy, Suite 100, Centreville, VA 20120-1995 | 2008-06-13 |
| 1659349447 | Kenneth R Bergman Jr. | Otolaryngology | 14631 Lee Hwy, Ste 413, Centreville, VA 20121-5824 | 2006-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174005417 | Roanoke Valley Ent & Allergy PC | Otolaryngology | 2154 Mcvitty Rd, Second Floor, Roanoke, VA 24018 | 2018-09-04 |
| 1629459243 | Kevin James Quinn | Otolaryngology | 1200 E Broad St # 980257, Richmond, VA 23298 | 2015-06-10 |
| 1356778641 | Stat, LLC | Otolaryngology | 10812 Weather Vane Rd, Richmond, VA 23238-4161 | 2013-10-01 |
| 1134564073 | Ear, Nose, Throat & Allergy Consultants, PC | Otolaryngology | 26208 Lee Highway, Abingdon, VA 24211-7504 | 2013-05-06 |
| 1467790477 | Marco Aurelio Merida | Otolaryngology | 7216 Farm Meadow Ct, Mc Lean, VA 22101-5657 | 2013-01-25 |
| 1609142355 | Neelima Tummala | Otolaryngology | 1860 Town Center Dr Ste 420, Reston, VA 20190-5901 | 2012-03-27 |
| 1346512225 | John Laurence Manwaring | Otolaryngology | 7734 Retreat Ln, Warrenton, VA 20186-7546 | 2012-02-07 |
| 1508151887 | Jose Luis Mattos | Otolaryngology | 415 Ray C. Hunt Dr Ste 2200, Charlottesville, VA 22903-0001 | 2011-06-14 |
| 1982998852 | Blue Ridge Medical Management Corporation | Otolaryngology | 7021 W Lee Highway, Suite B, Rural Retreat, VA 24368-0000 | 2011-06-08 |
| 1609168327 | Jae Y Kim | Otolaryngology | 2200 Wilson Blvd Ste 102-219, Arlington, VA 22201-3397 | 2011-05-12 |
| Find all providers with the same taxonomy | ||||
| City | CENTREVILLE |
| Zip Code | 20121 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.