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PEDIATRIC HEALTHCARE
NPI 1083890404
Pediatrics in Leesburg, VA

Active since January 16, 2008CLIA 49D0892720 · Waiver
224-D CORNWALL STREET, NW, SUITE 104, LEESBURG, VA 20176(703) 779-0699(703) 779-7712 Get Directions Write a Review

NPPES record last updated: September 27, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 27, 2022, Mar 4, 2022, Aug 11, 2021 (3 updates tracked since 2021).

About Pediatric Healthcare NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC HEALTHCARE (NPI 1083890404) is a healthcare organization registered as a pediatrics in Leesburg, Virginia and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through November 12, 2027 and lists Mary Beth Tamasy, Ceo, as its authorized official.

NPPES Registry Identity

NPI1083890404
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameLOUDOUN MEDICAL GROUP, PC
Location Address224-D CORNWALL STREET, NW, SUITE 104Leesburg, VA 20176-2700
Mailing Address224-d Cornwall Street, Nw, Suite 403Leesburg, VA 20176-2704 · (703) 737-6010 · Fax (703) 443-8643
Phone(703) 779-0699
Fax(703) 779-7712
Organization SubpartYes
Authorized OfficialMary Beth TamasyCeo · (703) 737-6010
Enumeration DateJanuary 16, 2008
Last NPPES UpdateSeptember 27, 20223 updates tracked since enumeration
NPPES CertifiedSeptember 27, 2022
✔ NPI 1083890404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
224-D CORNWALL STREET, NW, SUITE 104, Leesburg, VA 20176
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Other Names 1

Doing Business AsPediatric Healthcare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D0892720

Pediatric Healthcare · Leesburg, VA
Active · expires Nov 12, 2027
CLIA Number49D0892720
Laboratory TypePhysician Office
Certificate Effective DateNovember 13, 2025
Certificate Expiration DateNovember 12, 2027
Laboratory DirectorKimberly S. Kolb
Laboratory Phone(703) 779-0699
Laboratory LocationPediatric Healthcare224-D Cornwall Street, Suite 104, Leesburg, VA 20176
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REBECCA GIOVANNACCI FNP-BC
Nurse Practitioner (Family)
224-D CORNWALL STREET, NW, SUITE 104
LEESBURG, VA 20176
Loudoun County (703) 779-0699

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Loudoun Medical Group, PC's NPI number?

The NPI number for Loudoun Medical Group, PC is 1083890404. It was assigned to this organization in the NPPES registry on January 16, 2008. The provider is doing business as Pediatric Healthcare.

Where is Loudoun Medical Group, PC located?

Loudoun Medical Group, PC is located at 224-D Cornwall Street, NW, Suite 104, Leesburg, VA 20176. The listed phone number is (703) 779-0699.

What is Loudoun Medical Group, PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Loudoun Medical Group, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D0892720) is associated with this NPI, valid through November 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Loudoun Medical Group, PC was last updated on September 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.