LOUDOUN MEDICAL GROUP, P.C. (NPI# 1235664897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235664897 |
| Entity Type | Organization |
| Organization Name | LOUDOUN MEDICAL GROUP, P.C. |
| Other Organization Name | UROGYNECOLOGY CENTER OF NORTHERN VIRGINIA |
| Practice Address |
1860 Town Center Dr Suite 140 Reston VA 20190-5896 |
| Mailing Address |
224d Cornwall St Nw Suite 403 Leesburg VA 20176-2700 |
| Practice Telephone | 7038400665 |
| Practice Fax Number | 5713461924 |
| Mailing Telephone | 7037376001 |
| Mailing Fax Number | 7034438643 |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2019-01-07 |
| Authorized Official Name | MARY BETH TAMASY (CEO) |
| Authorized Official Telephone | 7037376012 |
| Is Organization Subpart | Y |
| Parent Organization Name | LOUDOUN MEDICAL GROUP, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2088F0040X |
Urology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Urogynecology Center of Northern Virginia | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6845 Elm St Ste 708, Mc Lean, VA 221013851 | 7032935239 | 5715264393 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447760186 | Loudoun Medical Group, P.C. | Obstetrics & Gynecology | 10400 Eaton Pl Ste 430, Fairfax, VA 22030-2208 | 2017-10-09 |
| 1902325608 | Loudoun Medical Group, P.C. | Family Medicine | 224d Cornwall St Nw Ste 102, Leesburg, VA 20176-2700 | 2017-09-13 |
| 1609900208 | Loudoun Medical Group, P.C. | Internal Medicine | 44055 Riverside Pkwy Ste 216, Leesburg, VA 20176-5176 | 2007-03-15 |
| 1427617422 | Loudoun Medical Group, P.C. | Physical Therapist | 19490 Sandridge Way Ste 230, Leesburg, VA 20176-3467 | 2019-06-12 |
| 1386203628 | Loudoun Medical Group, P.C. | Physical Therapist | 6408 Grovedale Dr Ste 102, Alexandria, VA 22310-2596 | 2019-06-11 |
| 1447817689 | Loudoun Medical Group, P.C. | Pathology | 6736 Curran St Ste 1, Mc Lean, VA 22101-3803 | 2019-05-23 |
| 1356907612 | Loudoun Medical Group, P.C. | Clinic/Center | 5901 Kingstowne Village Pkwy Ste 300, Kingstowne, VA 22315-5883 | 2019-05-13 |
| 1295290286 | Loudoun Medical Group, P.C. | Urology | 1860 Town Center Dr Ste 180, Reston, VA 20190-5905 | 2019-02-05 |
| 1346710084 | Loudoun Medical Group, P.C. | Internal Medicine | 24585 Stone Carver Dr Ste 100, Aldie, VA 20105-2798 | 2018-11-26 |
| 1962978569 | Loudoun Medical Group, P.C. | Clinic/Center | 19490 Sandridge Way Ste 240, Leesburg, VA 20176-3467 | 2018-10-22 |
| Street Address |
1860 TOWN CENTER DR SUITE 140 |
| City | RESTON |
| State | VA |
| Zip Code | 20190-5896 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396743688 | Eric B Masternick | Podiatrist | 1860 Town Center Dr, Suite 220, Reston, VA 20190-5896 | 2005-07-11 |
| 1881204824 | Amar Rajbir Singh Gill | Physician Assistant | 1860 Town Center Dr, Reston, VA 20190-5896 | 2020-08-04 |
| 1518431576 | Amanda Joan Field | Physician Assistant | 1860 Town Center Dr, Reston, VA 20190-5896 | 2019-01-13 |
| 1144777541 | Leanne Mcnabney | Physical Therapist | 1860 Town Center Dr, Suite 300, Reston, VA 20190-5896 | 2016-09-02 |
| 1912451238 | Emily Anne Sunkin | Physician Assistant | 1860 Town Center Dr, Suite 335, Reston, VA 20190-5896 | 2016-08-04 |
| 1033587365 | Gabrielle Pham-che | Physical Therapist | 1860 Town Center Dr, Reston, VA 20190-5896 | 2015-09-03 |
| 1639545353 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 1860 Town Center Dr, Suite 220, Reston, VA 20190-5896 | 2015-08-17 |
| 1992197685 | Northern Virginia Hearing Aid LLC | Hearing Aid Equipment | 1860 Town Center Dr, Suite 225, Reston, VA 20190-5896 | 2015-03-04 |
| 1316339625 | Susan Hansen | Physical Therapy Assistant | 1860 Town Center Dr, Reston, VA 20190-5896 | 2015-02-24 |
| 1578954848 | Tanya Galofaro Dpt | Physical Therapist | 1860 Town Center Dr, Suite 300, Reston, VA 20190-5896 | 2015-02-09 |
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|---|---|---|---|---|
| 1912548470 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1906 Reston Metro Plaza, Suite 100, Reston, VA 20190 | 2019-10-04 |
| 1205483260 | Northern Virginia Applied Behavior Analysis, L.L.C. | Behavioral Analyst | 1984 Issac Newton Square West, Suite 204, Reston, VA 20190 | 2019-08-23 |
| 1336796481 | Sandra Chiunda | Nurse Practitioner | 11484 Washington Plaza W 3rd Floor, Reston, VA 20190 | 2019-08-23 |
| 1891357232 | Beyond Counseling, Inc. | Clinic/Center | 11250 Roger Bacon Dr., Atrium 5, Reston, VA 20190 | 2019-07-06 |
| 1003470063 | Sarah Katharina Jungnitsch | Registered Nurse | Reston Anesthesia Associates, 11341 Sunset Hills Road, Reston, VA 20190 | 2019-04-25 |
| 1194202341 | May Health Care Services Inc | Home Health | 12110 Sunset Hills Road Suite 600, Reston, VA 20190 | 2018-07-20 |
| 1245739895 | Carlee B. Genung | Physician Assistant | 1760 Reston Parkway Suite 306, Reston, VA 20190 | 2018-02-09 |
| 1760901045 | Kristen Kelly | Dietitian, Registered | 11703 Bowman Green Drive, Lower Level, Reston, VA 20190 | 2017-09-18 |
| 1245778992 | Sarah Christine Bernstein | Occupational Therapist | 1860 Town Center Drive Ste, Suite 300, Reston, VA 20190 | 2017-02-02 |
| 1023495298 | Phillip Nguyen | Dentist | 1800 Town Center Dr Ste 116, Reston, VA 20190 | 2015-04-27 |
| Find all providers in zip 20190 | ||||
| Taxonomy Code | 2088F0040X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Female Pelvic Medicine and Reconstructive Surgery |
| A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. |
| Notes: Source: American Board of Medical Specialties, 2011. [1/1/2012: new] Resources: www.abms.org |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811351166 | Loudoun Medical Group PC | Urology | 1830 Town Center Dr, Suite 306, Reston, VA 20190-3292 | 2016-04-12 |
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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.