LOUDOUN MEDICAL GROUP PC (NPI# 1629238597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629238597 |
| Entity Type | Organization |
| Organization Name | LOUDOUN MEDICAL GROUP PC |
| Other Organization Name | NORTHERN VIRGINIA ENT ASSOCIATES-CENTERVILLE OFFICE |
| Practice Address |
5895 Trinity Pkwy Suite 100 Centreville VA 20120-1995 |
| 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 | 2008-06-13 |
| Last Update Date | 2008-06-13 |
| Authorized Official Name | JAMES A LAPSLEY (CEO) |
| Authorized Official Telephone | 7037376014 |
| 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-Centerville office | 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 |
5895 TRINITY PKWY SUITE 100 |
| City | CENTREVILLE |
| State | VA |
| Zip Code | 20120-1995 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992709265 | Alan R Levinstone | Internal Medicine | 5895 Trinity Pkwy, Suite 100, Centreville, VA 20120-1996 | 2005-06-02 |
| 1477870541 | Mariya Bourget | Internal Medicine | 5895 Trinity Pkwy, Suite 100, Centreville, VA 20120-1995 | 2010-04-28 |
| 1811150899 | Susan S Fitzgerald | Nurse Practitioner | 5895 Trinity Pkwy, Suite 100, Centreville, VA 20120-1995 | 2008-07-09 |
| 1063675205 | Pauline Abate | Nurse Practitioner | 5895 Trinity Pkwy, Suite 100, Centreville, VA 20120-1995 | 2008-07-08 |
| 1568624054 | Kathleen Shearer | Nurse Practitioner | 5895 Trinity Pkwy, Suite 100, Centreville, VA 20120-1995 | 2008-06-26 |
| 1679755425 | Louise A Leblanc | Nurse Practitioner | 5895 Trinity Pkwy, Suite 100, Centreville, VA 20120-1995 | 2007-12-04 |
| 1891813242 | Katherine Buran Fischer | Dentist | 5895 Trinity Pkwy, Suite 200, Centreville, VA 20120-1921 | 2007-03-26 |
| 1306964770 | Charles Curt Fischer | Dentist | 5895 Trinity Pkwy, Suite 200, Centreville, VA 20120-1921 | 2007-03-26 |
| 1912078619 | Clifton Centreville Medical Associates | Family Medicine | 5895 Trinity Pkwy, Suite 100, Centreville, VA 20120-1995 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675477 | Happy Healthy Healing Pllc | Counselor | 5675 Stone Rd., Suite 310, Centreville, VA 20120 | 2019-05-21 |
| 1346725322 | Margo Flores Dds Pllc | Dentist | 5703 Centre Square Drive, Centreville, VA 20120 | 2018-09-26 |
| 1699274753 | Sarah Caitlin Brown | Nurse Practitioner | 5895 Trinity Pkwy Ste 100, Centreville, VA 20120 | 2018-02-05 |
| 1437687605 | Young Min Kim | Dentist | 5703 Centre Square Dr, Centreville, VA 20120 | 2017-05-31 |
| 1922349513 | Kristina Kallini | Social Worker | 13525 Leland Rd., Centreville, VA 20120 | 2013-03-07 |
| 1225209018 | About Care Obgyn Associates PC | Obstetrics & Gynecology | 6134 Redwood Square Center, Unit 101, Centreville, VA 20120 | 2008-03-19 |
| 1649486747 | Dulles Dental Group LLC | Dentist | 5103 Westfields Blvd, Centreville, VA 20120 | 2007-05-15 |
| 1356482657 | Kevin Michael Skinner | Dentist | 5651 Stone Rd, Centreville, VA 20120 | 2007-02-09 |
| 1952452856 | Jose Rodrigo Charcon | Physical Therapy Assistant | 5719 Centre Square Dr, Centreville, VA 20120 | 2007-01-16 |
| 1033122981 | Charles & Katherine Fischer Dds PC | Dentist | 5895 Trinity Parkway, Suite 200, Centreville, VA 20120 | 2006-08-14 |
| Find all providers in zip 20120 | ||||
| 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 |
|---|---|---|---|---|
| 1144543018 | Loudoun Medical Group PC | Otolaryngology | 14631 Lee Hwy, Suite 405, Centreville, VA 20121-5824 | 2010-03-08 |
| 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 | 20120 |
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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.