Privia Medical Group, LLC · Otolaryngology Physician

19465 Deerfield Ave Ste 207, Leesburg, VA 20176-1703

Overview

Privia Medical Group, LLC is a Otolaryngology Physician (organization) practicing in Leesburg, Virginia. The National Provider Identifier (NPI) is #1306631668, which was assigned on April 9, 2025, and the registration record was last updated on April 9, 2025. The practitioner's main practice location is at 19465 Deerfield Ave Ste 207, Leesburg, VA 20176-1703; the contact telephone number is 7036876001. The primary taxonomy of Privia Medical Group, LLC is Otolaryngology Physician (207Y00000X). The authorized official for Privia Medical Group, LLC is Allison Hennessey (Authorized Official).

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.

Provider Information

NPI 1306631668
Entity Type Organization
Organization Name PRIVIA MEDICAL GROUP, LLC
Provider Name PRIVIA MEDICAL GROUP, LLC
Practice Address 19465 Deerfield Ave Ste 207
Leesburg
VA 20176-1703
Practice Telephone 7036876001
Mailing Address 950 N Glebe Rd Ste 700
Arlington
VA 22203-4173
Mailing Telephone 8009731442
Certification Date 2025-04-09
Enumeration Date 2025-04-09
Last Update Date 2025-04-09
Is Organization Subpart N

Authorized Official Information

Official Name ALLISON HENNESSEY
Official Title AUTHORIZED OFFICIAL
Telephone 3042769254

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y207Y00000XOtolaryngology193200000X MULTI-SPECIALTY GROUP

Providers with the same name

Provider NameAddressTaxonomyEnumeration Date
Privia Medical Group, LLC 8109 Hinson Farm Rd Ste 504, Alexandria, VA 22306-3411Internal Medicine Physician2025-04-09
Privia Medical Group, LLC 3025 Hamaker Ct Ste 100, Fairfax, VA 22031-2229Cardiovascular Disease Physician2025-04-09
Privia Medical Group, LLC 17341 Melford Blvd Ste L-M, Bowie, MD 20715-4457Pediatrics Physician2025-10-04
Privia Medical Group, LLC 101 Fleet St, Rockville, MD 20850-2309Internal Medicine Physician2025-05-09
Privia Medical Group, LLC 9 Saint Paul St Ste 3, Boonsboro, MD 21713-1334Physician Assistant2025-07-08
Privia Medical Group, LLC 6100 Executive Blvd Ste 300, Rockville, MD 20852-3913Internal Medicine Physician2025-10-04
Privia Medical Group, LLC 8401 Connecticut Ave Ste 200-01, Chevy Chase, MD 20815-5803Pediatric Nurse Practitioner2025-04-09
Privia Medical Group, LLC 1880 Howard Ave Ste 202, Vienna, VA 22182-2611Physician Assistant2025-04-09
Privia Medical Group, LLC 7525 Greenway Center Dr Ste 312, Greenbelt, MD 20770-3525Internal Medicine Physician2025-04-09
Privia Medical Group, LLC 2800 S Shirlington Rd Ste 300, Arlington, VA 22206-3623Cardiovascular Disease Physician2025-04-09
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Taxonomy Information

Primary Taxonomy

Code 207Y00000X
Taxonomy Otolaryngology Physician
Classification Otolaryngology
Grouping Allopathic & Osteopathic Physicians
Definition: 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: definition 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.

Providers with the same taxonomy

Provider NameAddressTaxonomyEnumeration Date
Forsyth Medical Group LLC 1994 Wellness Blvd Ste 210, Monroe, NC 28110-7768Otolaryngology Physician2025-08-28
Aesthetic Institute of Oklahoma PLLC 4509 Integris Pkwy Ste 350, Edmond, OK 73034-8696Otolaryngology Physician2025-08-01
Morgan Beck 108 Cowpath Rd Ste 2, Lansdale, PA 19446-1152Otolaryngology Physician2025-10-09
Medlegal Teams Khavkin Md PLLC 5380 S Rainbow Blvd Ste 306, Las Vegas, NV 89118-1880Otolaryngology Physician2025-09-24
Vienne Metoyer Brown 1800 Peachtree St Nw Ste 400, Atlanta, GA 30309-2514Otolaryngology Physician2025-10-06
Lifebridge Community Physicians Inc 215 Schilling Cir Ste 110, Hunt Valley, MD 21031-1112Otolaryngology Physician2025-06-27
Lifebridge Community Physicians Inc 1954 Greenspring Dr, Timonium, MD 21093-4111Otolaryngology Physician2025-06-27
Greater Baltimore Medical Center, Inc. 6569 N Charles St Ste 402, Baltimore, MD 21204-5814Otolaryngology Physician2025-08-07
Shadi Shinnawi 2521 Stockton Blvd Ste 7200, Sacramento, CA 95817-2207Otolaryngology Physician2025-07-14
Ibtisam Mohammad 1120 15th St # Bp-4109, Augusta, GA 30912-0006Otolaryngology Physician2025-06-26
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Location Information

Street Address 19465 DEERFIELD AVE STE 207
City LEESBURG
State VA
Zip Code 20176-1703
Country US

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Atiyeh Emam 44135 Woodridge Parkway, Suite 280, Leesburg, VA 20176General Practice Dentistry2006-01-03
Kaie Manor 211 Gibson Street, Nw, Suite 215, Leesburg, VA 20176-2115Family Nurse Practitioner2025-02-26
Karen Ann Mazzara 44084 Riverside Pkwy #240, Leesburg, VA 20176Professional Counselor2006-11-21
Myeyedr Optometry of Virginia, PLLC 617 Potomac Station Dr Ne Ste A, Leesburg, VA 20176-1817Optometrist2025-06-26
Riverside Couseling Center 44084 Riverside Parkway 240, Leesburg, VA 20176Psychiatry Physician2007-01-03
Nadia Ramadhin 224-D Cornwall Street, Nw, Suite 403, Leesburg, VA 20176-2017Speech-Language Pathologist2019-07-03
The Williams Center for Health and Community Education 211 Gibson St Nw Ste 123, Leesburg, VA 20176-2115Addiction (Substance Use Disorder) Counselor2025-06-02
Clifford C Souder 601 Potomac Station Dr Ne, Leesburg, VA 20176-1816Physician Assistant2008-02-06
Craig Ernest Vigliante 19440 Golf Vista Plaza, Ste 130, Leesburg, VA 20176Oral & Maxillofacial Surgery (D.M.D.)2006-11-07
Atiyeh Emam Dds PLLC 44135 Woodridge Pkwy Ste 280, Lansdowne, VA 20176-1244Customized Equipment (DME)2025-06-05
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Similar Providers

Providers with similar names

Provider NameAddressTaxonomyEnumeration Date
Privia Medical Group Indiana, LLC 410 Park Pl Ste A, Mishawaka, IN 46545-3557Family Medicine Physician2006-09-15
Privia Medical Group Indiana, LLC 2115 W Lexington Ave, Elkhart, IN 46514-1423Family Medicine Physician2009-04-06
Privia Medical Group Indiana, LLC 410 Park Pl, Suite B, Mishawaka, IN 46545-3557Multi-Specialty Clinic/Center2008-04-22
Privia Medical Group Arizona, LLC 111 W Cedar Ln Ste A, Payson, AZ 85541-5417Family Medicine Physician2008-02-25
Hand and Orthopedic Medical Associates, A Professional Medical Corpora 8555 Florence Ave, Downey, CA 90240-4014Orthopaedic Hand Surgery Physician2024-07-10
Privia Medical Group Indiana, LLC 100 N. Elkhart St, Wakarusa, IN 46573Family Nurse Practitioner2023-06-15
Privia Medical Group Indiana, LLC 2222 W Lexington Ave, Suite B, Elkhart, IN 46514-1420Multi-Specialty Clinic/Center2016-10-18
Privia Medical Group Arizona, LLC 3815 E Bell Rd Ste 4500, Phoenix, AZ 85032-2171Pain Medicine (Anesthesiology) Physician2006-03-22
Privia Medical Group Washington, PLLC 905 E D St, Deer Park, WA 99006-5167Rural Health Clinic/Center2025-02-12
Privia Medical Group Indiana, LLC 2222 W Lexington Ave, Elkhart, IN 46514-1420Ophthalmology Physician2015-11-05

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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.