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Privia Medical Group Tennessee LLC — NPI 1508523515, Antioch, TN | NPI Central

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NPI 1508523515

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Privia Medical Group Tennessee LLC

NPI 1508523515 · Sports Medicine (Orthopaedic Surgery) Physician · Antioch, TN

Provider details

NPI number: 1508523515
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

Sports Medicine (Orthopaedic Surgery) PhysicianPrimary207XX0005X
Allopathic & Osteopathic Physicians

Practice location

5380 Hickory Hollow Pkwy Ste 201

Antioch, TN 37013-3389

Phone: (571) 982-8850

Approximate (ZIP-level) locationGet directions

More TN providers

Mailing address

950 N Glebe Rd Ste 700

Arlington, VA 22203-4173

Other names (DBA / former)

Doing business as: Sports Ortho Urgent Care
Doing business as: Sports Ortho Urgent Care

Registry dates

Enumerated: 2021-11-24
Last updated: 2022-07-13
Certified: 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.