Privia Medical Group Tennessee LLC
NPI 1205582087 · Sports Medicine (Orthopaedic Surgery) Physician · Mt Juliet, TN
Enrolled with Medicare as Dme Supplier - Physician - Orthopedic/Orthopedic Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Privia Medical Group Tennessee LLC is a Sports Medicine (Orthopaedic Surgery) Physician organization in Mt Juliet, TN (NPI 1205582087).
Provider details
- NPI number
- 1205582087
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mary Roller, Associate Director/Enrollment(770) 312-5226
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
Mailing address
Other names (DBA / former)
- Doing business as
- Sports Ortho Urgent Care
- Doing business as
- Sports Ortho Urgent Care
Registry dates
- Enumerated
- 2022-03-01
- Last updated
- 2022-07-13
- Certified
- 2022-07-13
Frequently asked questions
- What is Privia Medical Group Tennessee LLC's NPI number?
- Privia Medical Group Tennessee LLC's National Provider Identifier (NPI) is 1205582087, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Privia Medical Group Tennessee LLC?
- Privia Medical Group Tennessee LLC is classified in the NPPES registry as Sports Medicine (Orthopaedic Surgery) Physician (Allopathic & Osteopathic Physicians).
- Where is Privia Medical Group Tennessee LLC located?
- Privia Medical Group Tennessee LLC's practice location on file with NPPES is 4998 Crossings Cir Ste 200, Mt Juliet, TN 37122-0018.
- What is Privia Medical Group Tennessee LLC's phone number?
- The practice phone number listed in the NPPES registry for Privia Medical Group Tennessee LLC is (615) 553-5000.
- Does Privia Medical Group Tennessee LLC accept Medicare?
- Privia Medical Group Tennessee LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Privia Medical Group Tennessee LLC?
- The authorized official listed on Privia Medical Group Tennessee LLC's NPPES record is Mary Roller, Associate Director/Enrollment. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Privia Medical Group Tennessee LLC's NPI active?
- Yes — Privia Medical Group Tennessee LLC's NPI (1205582087) is active in the NPPES registry as of the last update on 2022-07-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.