LOUDOUN MEDICAL GROUP PC (NPI# 1174879944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174879944 |
| Entity Type | Organization |
| Organization Name | LOUDOUN MEDICAL GROUP PC |
| Other Organization Name | PHYSICIANS PRACTICE AND RESEARCH |
| Practice Address |
19415 Deerfield Ave Suite 107 Leesburg VA 20176-8452 |
| Mailing Address |
Po Box 17334 Baltimore MD 21297-1334 |
| Practice Telephone | 7037235555 |
| Practice Fax Number | 7035626996 |
| Mailing Telephone | 7034436717 |
| Mailing Fax Number | 7034438643 |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2012-07-31 |
| Authorized Official Name | MARY BETH TAMASY (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 | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Physicians Practice and Research | 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 |
19415 DEERFIELD AVE SUITE 107 |
| City | LEESBURG |
| State | VA |
| Zip Code | 20176-8452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558745794 | Loudoun Medical Group PC | Surgery | 19415 Deerfield Ave, Suite 213, Leesburg, VA 20176-8452 | 2015-07-17 |
| 1649662339 | Crescent Medical Arts | Internal Medicine | 19415 Deerfield Ave, Suite 213, Leesburg, VA 20176-8452 | 2015-03-04 |
| 1821492067 | Kelly Ashley Boardman | Physician Assistant | 19415 Deerfield Ave, Suite 213, Leesburg, VA 20176-8452 | 2014-10-17 |
| 1356780746 | Rachel Swinger Sposito | Nurse Practitioner | 19415 Deerfield Ave, Suite 202, Leesburg, VA 20176-8452 | 2013-06-18 |
| 1093066284 | Mari E Parker | Nurse Practitioner | 19415 Deerfield Ave, Suite 112, Leesburg, VA 20176-8452 | 2012-09-27 |
| 1366709651 | Loudoun Medical Group PC | Pediatrics | 19415 Deerfield Ave, Suite 213, Leesburg, VA 20176-8452 | 2012-04-12 |
| 1093091530 | Navin Hukmani, Dds, LLC | Dentist | 19415 Deerfield Ave, Suite 306, Leesburg, VA 20176-8452 | 2011-10-28 |
| 1922325000 | Kathleen I Cage | Nurse Practitioner | 19415 Deerfield Ave, Suite 112, Leesburg, VA 20176-8452 | 2010-04-28 |
| 1588827968 | Christopher L. Starks | Urology | 19415 Deerfield Ave, Suite112, Leesburg, VA 20176-8452 | 2008-07-07 |
| 1740479971 | Jennifer Lee Young | Urology | 19415 Deerfield Ave, Suite 112, Leesburg, VA 20176-8452 | 2007-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912923 | Timothy Michael Nixon | Pharmacist | 61 Catoctin Circle, Leesburg, VA 20176 | 2020-11-05 |
| 1558996645 | Stacey E Moran | Occupational Therapist | 44124 Woodrige Parkway, Lansdowne, VA 20176 | 2020-03-09 |
| 1710531272 | Joseph H Kasuska Jr. | Specialist/Technologist | 19455 Deerfield Ave. Suite 306, Lansdowne, VA 20176 | 2019-08-01 |
| 1568935849 | Joel Manalang Polintan Jr. | Physical Therapist | 171 Cedarwalk Circle, Leesburg, VA 20176 | 2019-01-09 |
| 1194203026 | Jing Cao | Acupuncturist | 19450 Deerfield Ave Ste 275, Leesburg, VA 20176 | 2018-08-02 |
| 1134648314 | Alaina Marie Gotwalt | Speech-Language Pathologist | 43850 Heatherstone Terrace, Unit 406, Leesburg, VA 20176 | 2017-09-19 |
| 1841717105 | Happy Inhome Care Corp | Respite Care | 722 E Market St Ste 103, Leesburg, VA 20176 | 2017-08-28 |
| 1912423484 | Aaa Good Healthcare LLC | Nursing Care | 722 East Market Street Ne, Suite 102, Leesburg, VA 20176 | 2017-08-16 |
| 1740704253 | Anna Maria Domingo Seaford | Physician Assistant | 19441 Golf Vista Plz Ste 230, Lansdowne, VA 20176 | 2017-07-27 |
| 1710436480 | Reena Patel | Physician Assistant | 224 Cornwall St Nw Leesburg Orthope, Unit 204, Leesburg, VA 20176 | 2016-09-23 |
| Find all providers in zip 20176 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558535591 | Quintina B. Corteza Md Pa | Internal Medicine | 401 E. North Blvd, Suite 102a, Leesburg, FL 34748 | 2008-04-22 |
| 1013181650 | Gerardo J Rodriguez M D P A | Internal Medicine | 611 W Dixie Ave, Leesburg, FL 34748-2602 | 2008-04-15 |
| 1164906871 | Quality Physician Group Pllc | Internal Medicine | 33049 Professional Dr Ste 103, Leesburg, FL 34788-3705 | 2018-09-18 |
| 1083920383 | Ingrid Kisha Nidra Calliste | Internal Medicine | 511 Medical Plaza Dr Ste 101, Leesburg, FL 34748-7328 | 2010-08-24 |
| 1083825251 | Maria Theresa Silvano De Jesus | Internal Medicine | 401 E North Blvd, Suite 102a, Leesburg, FL 34748-5262 | 2007-05-26 |
| 1255348876 | Quintina B Corteza | Internal Medicine | 401 E North Blvd, Ste 102a, Leesburg, FL 34748 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316416522 | Southwest Virginia Nephrology LLC | Internal Medicine | 4806 Pleasant Hill Dr Ste 102, Roanoke, VA 24018-3440 | 2018-11-16 |
| 1780081059 | Belen Nunez | Internal Medicine | 3400 S Crater Rd Ste B, Petersburg, VA 23805-9252 | 2014-12-02 |
| 1770903585 | Salah-ud-din Amjad | Internal Medicine | 480 W Jubal Early Dr Ste 200, Winchester, VA 22601 | 2014-04-19 |
| 1699012005 | Barry S. Strauch | Internal Medicine | 1468 Evans Farm Dr, Mc Lean, VA 22101-5652 | 2013-01-07 |
| 1770858847 | Amanda D. Renaghan | Internal Medicine | 199 Spotnap Rd Ste 1, Charlottesville, VA 22911-8827 | 2012-03-21 |
| 1952671067 | Sumeyye Calp Inal | Internal Medicine | 739 Thimble Shoals Blvd Ste 801, Newport News, VA 23606 | 2012-01-05 |
| 1598080186 | Vineet Kumaar Jassal | Internal Medicine | 3930 Walnut St Ste 101, Fairfax, VA 22030-4750 | 2010-04-07 |
| 1538497698 | James Macleod Cox | Internal Medicine | 4222 Coles Point Way, Glen Allen, VA 23060-7242 | 2009-12-01 |
| 1568625408 | Mahesh Krishnan | Internal Medicine | 1371 Lancia Dr, Mc Lean, VA 22102-2230 | 2008-07-09 |
| 1194907527 | Usama Taha Hussein | Internal Medicine | 1800 Camelot Dr Ste 401, Virginia Beach, VA 23454-2440 | 2007-11-27 |
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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.