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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

PRIVIA MEDICAL GROUP, LLC
NPI 1891557476
Family Medicine in Waldorf, MD

Active since January 29, 2024
12070 OLD LINE CTR STE 302, WALDORF, MD 20602(301) 843-7667 Get Directions Write a Review

NPPES record last updated: July 10, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Privia Medical Group, Llc NPPES

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

PRIVIA MEDICAL GROUP, LLC (NPI 1891557476) is a healthcare organization registered as a family medicine in Waldorf, Maryland and active in the NPI registry since January 2024. The organization lists Brianna Foulkrod, Avp, as its authorized official.

NPPES Registry Identity

NPI1891557476
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePRIVIA MEDICAL GROUP, LLC
Location Address12070 OLD LINE CTR STE 302Waldorf, MD 20602-2567
Mailing Address950 N Glebe Rd Ste 700Arlington, VA 22203-4173 · (484) 569-9066
Phone(301) 843-7667
Organization SubpartNo
Authorized OfficialBrianna FoulkrodAvp · (571) 650-2710
Enumeration DateJanuary 29, 2024
Last NPPES UpdateJuly 10, 2026
NPPES CertifiedJuly 10, 2026
✔ NPI 1891557476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
12070 OLD LINE CTR STE 302, Waldorf, MD 20602
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

IVY WICKS MD
Family Medicine
12070 OLD LINE CTR STE 302
WALDORF, MD 20602
Charles County (301) 645-6667

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 Privia Medical Group, LLC's NPI number?

The NPI number for Privia Medical Group, LLC is 1891557476. It was assigned to this organization in the NPPES registry on January 29, 2024.

Where is Privia Medical Group, LLC located?

Privia Medical Group, LLC is located at 12070 Old Line Ctr Ste 302, Waldorf, MD 20602. The listed phone number is (301) 843-7667.

What is Privia Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Privia Medical Group, LLC was last updated on July 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 25 days 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.