0000950103-21-006545.txt : 20210430
0000950103-21-006545.hdr.sgml : 20210430
20210430213841
ACCESSION NUMBER: 0000950103-21-006545
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210428
FILED AS OF DATE: 20210430
DATE AS OF CHANGE: 20210430
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Butler Jeffrey B
CENTRAL INDEX KEY: 0001859428
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40365
FILM NUMBER: 21880944
MAIL ADDRESS:
STREET 1: 950 N. GLEBE RD., SUITE 700
CITY: ARLINGTON
STATE: VA
ZIP: 22101
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
dp150368_4-butler.xml
FORM 4
X0306
4
2021-04-28
0
0001759655
Privia Health Group, Inc.
PRVA
0001859428
Butler Jeffrey B
PRIVIA HEALTH GROUP, INC.
950 N. GLEBE RD., SUITE 700.
ARLINGTON
VA
22203
1
0
0
0
Common Stock, $0.01 par value per share
2021-04-28
4
A
0
7609
0
A
7609
D
Represents restricted stock units granted under the Issuer's 2021 Omnibus Incentive Plan that will become fully vested on the first anniversary of the grant date.
/s/ Thomas Bartrum, EVP, General Counsel
2021-04-30