0000950103-21-006548.txt : 20210430 0000950103-21-006548.hdr.sgml : 20210430 20210430214025 ACCESSION NUMBER: 0000950103-21-006548 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: Mehrotra Parth CENTRAL INDEX KEY: 0001858398 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40365 FILM NUMBER: 21880956 MAIL ADDRESS: STREET 1: 950 N. GLEBE RD. STREET 2: SUITE 700 CITY: ARLINGTON STATE: VA ZIP: 22203 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 dp150373_4-mehotra.xml FORM 4 X0306 4 2021-04-28 0 0001759655 Privia Health Group, Inc. PRVA 0001858398 Mehrotra Parth PRIVIA HEALTH GROUP, INC. 950 N. GLEBE RD., SUITE 700. ARLINGTON VA 22203 0 1 0 0 President and COO Common Stock, $0.01 par value per share 2021-04-28 4 A 0 97391 0 A 97391 D Stock Option (Right to Purchase) 23.00 2021-04-28 4 A 0 437481 0 A Common Stock 437481 3260862 D Represents restricted stock units granted under the Issuer's 2021 Omnibus Incentive Plan that will vest in substantially equal annual installments on the second, third and fourth anniversaries of the grant date. Represents stock options granted under the Issuer's 2021 Omnibus Incentive Plan that will vest in substantially equal annual installments on the second, third and fourth anniversaries of the grant date. The stock options will expire on the tenth anniversary of the grant date. /s/ Thomas Bartrum, EVP, General Counsel 2021-04-30