OrganizationActive
Countryside Ambulatory Surg Center
NPI 1073534012 · Ambulatory Surgical Clinic/Center · Leesburg, VA
Provider details
- NPI number
- 1073534012
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- John Grish, Chief Financial Officer(703) 858-6604
- License
- OH 652 (VA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
44045 Riverside Pkwy
Leesburg, VA 20176-5101
Phone: (703) 858-6000
Street-level locationGet directions
Mailing address
4 Pidgeon Hill Dr
Sterling, VA 20165-6101
Registry dates
- Enumerated
- 2006-07-23
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.