# PRIVIA MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154115467
- **Authorized official:** BRIANNA FOULKROD (AVP)
- **Authorized official phone:** (571) 650-2710

## Contact information

- **Practice address:** 10260 SILVERSIDE ST STE 100, IJAMSVILLE, MD 21754-9174
- **Practice address phone:** (301) 682-4100
- **Mailing address:** 950 N GLEBE RD STE 700, ARLINGTON, VA 22203-4173

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/09/2025
- **Last updated:** 01/27/2026