Individual provider Active NPI

Janine Cutinho

  • Chiropractor
  • Fairfax, VA
National Provider Identifier
1396410890
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104-557758 Issued in VA
Practice address
10721 Main St Ste 1500
Fairfax, VA 22030-6910
Phone
(703) 373-7113
NPI assigned
Aug 16, 2021
Last updated
Jul 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104-557758 VA Primary

Addresses

Primary practice location

10721 Main St Ste 1500
Fairfax, VA 22030-6910

Mailing address

10721 Main St Ste 1500
Fairfax, VA 22030-6910
Phone (703) 373-7113

Other practice location 1

11350 Random Hills Rd Ste 300
Fairfax, VA 22030-7421
Phone (703) 373-7113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230816002813 DC Practitioner - Chiropractic 7416319868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee DC Active Family WellnessGroup PAC ID 7012377492, 6 clinicians

Practice addresses (Care Compare)

11350 Random Hills Rd
Suite 300
Fairfax, VA 22030-7421
Phone (703) 373-7113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104-557758VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Active Family Wellness PLLC Chiropractor CurrentSince Jun 17, 2023 Accepting new patients

Locations

10721 Main St
Ste 1500
Fairfax, VA 22030
Phone (703) 373-7113

11350 Random Hills Rd
Ste 300
Fairfax, VA 22030
Phone (703) 373-7113

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1396410890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST STE 1500",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306910",
            "telephone_number": "703-373-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST STE 1500",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306910",
            "telephone_number": "703-373-7113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11350 Random Hills Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220307421",
            "country_code": "US",
            "telephone_number": "703-373-7113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUTINHO",
        "first_name": "JANINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104-557758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.