Loudoun Rheumatology Center, PC

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

0101234395 Issued in VA

Legal business name

LOUDOUN RHEUMATOLOGY CENTER, PC

Practice address

19465 Deerfield Ave
Suite 309
Lansdowne, VA 20176-8446

Phone

(703) 723-3398

NPI assigned

Jun 19, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jennifer Odutola, M.D.NPI 1750397725

Title

Medical Director

Phone

(703) 723-3398

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Tax ID family

Loudoun Rheumatology Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Loudoun Rheumatology Center, PC

  • Rheumatology Physician
  • Purcellville, VA
  • NPI 1255525895
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Odutola, MD

  • Rheumatology Physician
  • Lansdowne, VA
  • NPI 1750397725
  Medicare reassignment Care Compare group NPD Authorized official
• Gulrukh Saleem, M.D.

  • Rheumatology Physician
  • Leesburg, VA
  • NPI 1750376562
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1376748426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19500 SANDRIDGE WAY STE 170",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201763692",
            "telephone_number": "703-723-3398",
            "fax_number": "703-723-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19465 DEERFIELD AVE",
            "address_2": "SUITE 309",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201768446",
            "telephone_number": "703-723-3398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Hirst Rd Ste 304",
            "address_purpose": "LOCATION",
            "city": "Purcellville",
            "state": "VA",
            "postal_code": "201326602",
            "country_code": "US",
            "telephone_number": "703-723-3398",
            "fax_number": "703-723-9128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LOUDOUN RHEUMATOLOGY CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "ODUTOLA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "703-723-3398",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "VA",
            "license": "0101234395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376748426",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Loudoun Family Medicine LLC
• Loudoun Family Medicine, P.C.
• Loudoun Internal and Lifestyle Medicine LLC
• Loudoun Medical Care PC
• Loudoun Medical Group, PC
• Loudoun Skilled Nursing LLC
• Loudoun Women'S Health
• Lucy S. Lee, O.D., P.L.L.C.
• Lynda Ly, PHARMD
• Cinthia Lyvers, FNP

• Rheumatology Physician in Lansdowne, VA
• Providers in Lansdowne, VA by specialty
• Rheumatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.