LOUDOUN MEDICAL GROUP PC (NPI# 1205171741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205171741 |
| Entity Type | Organization |
| Organization Name | LOUDOUN MEDICAL GROUP PC |
| Other Organization Name | FAMILY ALLERGY CENTER |
| Practice Address |
13890 Braddock Rd Suite 206 Centreville VA 20121-2435 |
| Mailing Address |
Po Box 17334 Baltimore MD 21297-1334 |
| Practice Telephone | 7032632333 |
| Practice Fax Number | 7032630361 |
| Mailing Telephone | 7034436717 |
| Mailing Fax Number | 7034438643 |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2012-12-11 |
| 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 | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Family Allergy Center | 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 |
13890 BRADDOCK RD SUITE 206 |
| City | CENTREVILLE |
| State | VA |
| Zip Code | 20121-2435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013912252 | Kenneth Robert Bergman | Allergy & Immunology | 13890 Braddock Rd, Ste 206, Centreville, VA 20121-2437 | 2005-06-15 |
| 1023556354 | Alexandra Miceli | Occupational Therapist | 13890 Braddock Rd, Ste. 207, Centreville, VA 20121-2435 | 2017-02-07 |
| 1538607254 | Kinder Life Pediatrics | Pediatrics | 13890 Braddock Rd, Suite 205, Centreville, VA 20121-2435 | 2017-02-01 |
| 1306201736 | Asma Jamil | Physician Assistant | 13890 Braddock Rd, #100, Centreville, VA 20121-2435 | 2015-12-30 |
| 1841672052 | Michael Mahoney Jr. | Speech-Language Pathologist | 13890 Braddock Rd, Ste. 207, Centreville, VA 20121-2435 | 2015-06-24 |
| 1427438118 | N&s Dental Group | Dentist | 13890 Braddock Rd, 202, Centreville, VA 20121-2435 | 2015-06-08 |
| 1356721419 | Kelly Anne Fini | Physical Therapist | 13890 Braddock Rd, Ste 207, Centreville, VA 20121-2435 | 2015-06-04 |
| 1265832398 | Jacqueline Michelle Stiles | Physical Therapist | 13890 Braddock Rd, Suite 102, Centreville, VA 20121-2435 | 2014-08-26 |
| 1053747543 | Youngchul Jang | Chiropractor | 13890 Braddock Rd, Suite 200, Centreville, VA 20121-2435 | 2013-09-17 |
| 1477991990 | Jennifer Michelle Skaggs | Speech-Language Pathologist | 13890 Braddock Rd, Suite 205, Centreville, VA 20121-2435 | 2013-06-06 |
| Find all providers in the same location | ||||
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|---|---|---|---|---|
| 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 | 207KA0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| Specialization | Allergy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013912252 | Kenneth Robert Bergman | Allergy & Immunology | 13890 Braddock Rd, Ste 206, Centreville, VA 20121-2437 | 2005-06-15 |
| 1891996658 | Family Allergy Center,p.c. | Allergy & Immunology | 13890 Braddock Rd, Suite 206, Centreville, VA 20121-2435 | 2007-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610682 | Kaufman Allergy Asthma and Immunology, Pllc | Allergy & Immunology | 8320 Old Courthouse Rd Ste 310, Vienna, VA 22182-3831 | 2020-08-23 |
| 1962862672 | Fame Allergy, PC | Allergy & Immunology | 1002 Apperson Dr, Salem, VA 24153-7133 | 2016-02-24 |
| 1346423381 | Vickie Kyuran Lee | Allergy & Immunology | 44320 Premier Plz, Suite #110, Ashburn, VA 20147-5076 | 2007-12-13 |
| 1871619452 | Allergy, Asthma and Sinus Center of Central Virginia | Allergy & Immunology | 3701 Boulevard Ste H, Colonial Heights, VA 23834-1339 | 2007-03-22 |
| 1053436451 | Hassan Mohagheghi | Allergy & Immunology | 3701 Boulevard, Suite H, Colonial Heights, VA 23834-1339 | 2007-03-21 |
| 1548340748 | Laura Ispas | Allergy & Immunology | 19455 Deerfield Ave Ste 207, Leesburg, VA 20176-8102 | 2006-10-16 |
| 1811092414 | Manuel Guillen | Allergy & Immunology | 101 34 D Colvin Run Road, Great Falls, VA 22066 | 2006-09-14 |
| 1871515296 | Albert L. Huber | Allergy & Immunology | 910 E High St, Charlottesville, VA 22902-4850 | 2006-07-24 |
| 1659302560 | Murali Dharan Sharath | Allergy & Immunology | 4534 Bonney Rd, Suite B, Virginia Beach, VA 23462-3873 | 2006-07-06 |
| 1932130531 | Kimberly C George | Allergy & Immunology | 201 Concourse Blvd, Ste 100, Glen Allen, VA 23059-5640 | 2006-07-05 |
| Find all providers with the same taxonomy | ||||
| City | CENTREVILLE |
| Zip Code | 20121 |
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.