LOUDOUN MEDICAL GROUP PC (NPI# 1194901512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194901512 |
| Entity Type | Organization |
| Organization Name | LOUDOUN MEDICAL GROUP PC |
| Other Organization Name | MDVIP |
| Practice Address |
224 D Cornwall Street Nw Suite 102 Leesburg VA 20176 |
| Mailing Address |
Po Box 17334 Baltimore MD 21297-1334 |
| Practice Telephone | 7037771146 |
| Practice Fax Number | 7037773144 |
| Mailing Telephone | 7034436717 |
| Mailing Fax Number | 7034438643 |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2014-04-30 |
| 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 | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | RRMEDICARE GROUP PIN | CG8678 | 01 |
| Other Name | Type Code |
|---|---|
| MDVIP | 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 |
224 D CORNWALL STREET NW SUITE 102 |
| City | LEESBURG |
| State | VA |
| Zip Code | 20176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346342565 | James Ticknor Gable | Orthopaedic Surgery | 224 D Cornwall Street Nw, Suite 204, Leesburg, VA 20176-4407 | 2006-09-01 |
| 1164698999 | Loudoun Medical Group PC | Orthopaedic Surgery | 224 D Cornwall Street Nw, Suite 204, Leesburg, VA 20176 | 2008-05-01 |
| 1619143443 | Loudoun Medical Group PC | Physical Medicine & Rehabilitation | 224 D Cornwall Street Nw, Suite 202, Leesburg, VA 20176 | 2008-05-01 |
| 1679759039 | Loudoun Medical Group PC | Urology | 224 D Cornwall Street Nw, Suite 400, Leesburg, VA 20176 | 2008-01-16 |
| 1912183294 | Loudoun Medical Group PC | Orthopaedic Surgery | 224 D Cornwall Street Nw, Suite 204, Leesburg, VA 20176 | 2008-01-16 |
| 1083890404 | Loudoun Medical Group PC | Pediatrics | 224 D Cornwall Street Nw, Suite 104, Leesburg, VA 20176 | 2008-01-16 |
| 1528244951 | Loudoun Medical Group PC | Family Medicine | 224 D Cornwall Street Nw, Suite106, Leesburg, VA 20176 | 2008-01-16 |
| 1831375294 | Loudoun Medical Group PC | Otolaryngology | 224 D Cornwall Street Nw, Suite 306, Leesburg, VA 20176 | 2008-01-16 |
| 1740466028 | Loudoun Medical Group PC | Orthopaedic Surgery | 224 D Cornwall Street Nw, Suite 204, Leesburg, VA 20176 | 2008-01-16 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1033679063 | Warren Joseph Marion | Internal Medicine | 38483 Forest Mills Rd, Leesburg, VA 20175 | 2019-03-25 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1124472873 | Adam Hines | Internal Medicine | 22381 Aging Oak Dr, Leesburg, VA 20175-4836 | 2016-04-19 |
| 1154714301 | Mid-atlantic Health Service Providers | Internal Medicine | 43713 Red House Dr, Leesburg, VA 20176-1628 | 2015-03-12 |
| 1104251370 | Mid-florida Primary Care Pa | Internal Medicine | 501 North Blvd West, Leesburg, FL 34748 | 2013-09-06 |
| 1013359975 | Lake Internal Medicine Pa | Internal Medicine | 293 Bent Oak Ct, Leesburg, FL 34748-9559 | 2013-07-20 |
| 1699069898 | Sepehr Mesdaghinia | Internal Medicine | 821 S King St Ste L, Leesburg, VA 20175-3922 | 2011-06-06 |
| 1003115098 | Amir Hesam Etemadnia | Internal Medicine | 1004 N 14th St, Leesburg, FL 34748-3850 | 2011-03-16 |
| 1518285139 | Sheyla Zelaya-aragon | Internal Medicine | 33049 Professional Dr Ste 103, Leesburg, FL 34788-3705 | 2010-05-06 |
| 1073845459 | Shakti Narain Md Pa | Internal Medicine | 1070 Flagler Ave, Leesburg, FL 34748-7633 | 2010-02-09 |
| Find all providers in LEESBURG | ||||
Please comment or provide details below to improve the information on LOUDOUN MEDICAL GROUP PC.
| 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.