0001268489-23-000010.txt : 20230803 0001268489-23-000010.hdr.sgml : 20230803 20230803163153 ACCESSION NUMBER: 0001268489-23-000010 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230801 FILED AS OF DATE: 20230803 DATE AS OF CHANGE: 20230803 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WICHMANN DAVID S CENTRAL INDEX KEY: 0001268489 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40365 FILM NUMBER: 231140629 MAIL ADDRESS: STREET 1: BOSTON SCIENTIFIC CORPORATION STREET 2: 300 BOSTON SCIENTIFIC WAY CITY: MARLBOROUGH STATE: MA ZIP: 01752 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Privia Health Group, Inc. CENTRAL INDEX KEY: 0001759655 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HEALTH SERVICES [8000] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 950 N. GLEBE RD., SUITE 700 CITY: ARLINGTON STATE: VA ZIP: 22203 BUSINESS PHONE: 571-366-8850 MAIL ADDRESS: STREET 1: 950 N. GLEBE RD., SUITE 700 CITY: ARLINGTON STATE: VA ZIP: 22203 FORMER COMPANY: FORMER CONFORMED NAME: PH Group Parent Corp. DATE OF NAME CHANGE: 20181120 4 1 wk-form4_1691094703.xml FORM 4 X0508 4 2023-08-01 0 0001759655 Privia Health Group, Inc. PRVA 0001268489 WICHMANN DAVID S PRIVIA HEALTH GROUP, INC. 950 N. GLEBE ROAD, SUITE 700 ARLINGTON VA 22203 1 0 0 0 0 Common Stock, par value $0.01 per share 1315340 I See Footnote Common Stock, par value $0.01 per share 2023-08-01 4 A 0 6189 0 A 6189 D Represents shares held by Jory Capital, LLC, which is co-owned by the Reporting Person. Represents restricted stock units granted under the Issuer's 2021 Omnibus Incentive Plan that will become fully vested on the day immediately preceding the date of Company's 2024 Annual Meeting of Stockholders. /s/ Thomas Bartrum, as attorney-in fact 2023-08-03