LOUDOUN MEDICAL GROUP, P.C. (NPI# 1962978569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962978569 |
| Entity Type | Organization |
| Organization Name | LOUDOUN MEDICAL GROUP, P.C. |
| Other Organization Name | LMG CANCER CENTER |
| Practice Address |
19490 Sandridge Way Ste 240 Leesburg VA 20176-3467 |
| Mailing Address |
224d Cornwall St Nw Ste 403 Leesburg VA 20176-2704 |
| Practice Telephone | 7036569805 |
| Practice Fax Number | 7037296573 |
| Mailing Telephone | 7037376001 |
| Mailing Fax Number | 7034438643 |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2018-11-01 |
| Authorized Official Name | MARY BETH TAMASY (CEO) |
| Authorized Official Telephone | 7037376001 |
| Is Organization Subpart | Y |
| Parent Organization Name | LOUDOUN MEDICAL GROUP, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0200X |
Clinic/Center Specialization: Oncology |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| LMG Cancer Center | Doing Business As Name - Organization |
| 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 |
| 1295201895 | Loudoun Medical Group, P.C. | Clinic/Center | 19490 Sandridge Way Ste 240, Leesburg, VA 20176-3467 | 2018-10-22 |
| Street Address |
19490 SANDRIDGE WAY STE 240 |
| City | LEESBURG |
| State | VA |
| Zip Code | 20176-3467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295201895 | Loudoun Medical Group, P.C. | Clinic/Center | 19490 Sandridge Way Ste 240, Leesburg, VA 20176-3467 | 2018-10-22 |
| 1083001663 | Loudoun Medical Group PC | Internal Medicine | 19490 Sandridge Way Ste 240, Leesburg, VA 20176-3467 | 2015-04-21 |
| 1699909093 | Mei-hwa Rose Firestone | Internal Medicine | 19490 Sandridge Way Ste 240, Leesburg, VA 20176-3467 | 2009-05-13 |
| 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 | 261QX0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Services include chemotherapy infusions and monitoring of implanted chemotherapeutic agents. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588727515 | Virginia Commonwealth University Health System | Clinic/Center | 8222 Meadowbridge Rd, Mechanicsville, VA 23116-2331 | 2006-12-19 |
| 1023179124 | Georgetown University Hospital | Clinic/Center | 3123 7th Street South, Arlington, VA 22204-2407 | 2006-12-12 |
| 1407218399 | Bon Secours | Clinic/Center | 14051 St Francis Blvd, Suite 2210, Midlothian, VA 23114-3201 | 2016-03-22 |
| 1386027019 | Hematology Oncology of Tysons Pllc | Clinic/Center | 380 Maple Ave W, 201, Vienna, VA 22180-5620 | 2015-06-30 |
| 1265616981 | Cnmc | Clinic/Center | 8301 Arlington Blvd, Suite 209, Fairfax, VA 22031-2902 | 2007-12-18 |
| 1932266400 | Virginia Commonwealth University Health System Authority | Clinic/Center | 9000 Stony Point Pkwy, Richmond, VA 23235-1900 | 2007-01-03 |
| 1982708236 | Medical Specialists of Fredericksburg Inc | Clinic/Center | 240 Executive Center Parkway, Fredericksburg, VA 22401-3107 | 2006-09-08 |
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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.