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