NPIMap

Organization Active NPI

Eastern Cranial Affiliates, LLC

Doing business as Infinite Life

  • Physical Therapy Clinic/Center
  • Fairfax, VA
National Provider Identifier
1437689932
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
EASTERN CRANIAL AFFILIATES, LLC
Doing business as
Infinite Life
Practice address
10523 Main St
Fairfax, VA 22030-3310
Phone
(703) 807-5899
Fax
(703) 807-1183
NPI assigned
Jun 16, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
EASTERN CRANIAL AFFILIATES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Joseph Terpenning
Title
Owner
Phone
(703) 807-5899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

10523 Main St
Fairfax, VA 22030-3310

Mailing address

10523 Main St
Fairfax, VA 22030-3310
Phone (703) 807-5899

Other names 1

  • Infinite Life Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181022000324 DC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0840406435 Receives reassigned benefits from 1 practitioner
Practice locations: Fairfax, VA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Eastern Cranial Affiliates LLC6 organizations share this tax ID, including this one
Part of
Eastern Cranial Affiliates LLC

Other organizations with this tax ID 5

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

Locations

1600 Wilson Blvd
Ste 200
Arlington, VA 22209
Phone (703) 807-5899

10523 Main St
Fairfax, VA 22030
Phone (703) 380-8141

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1497571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1437689932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10523 MAIN ST",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303310",
            "telephone_number": "703-807-5899",
            "fax_number": "703-807-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10523 MAIN ST",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303310",
            "telephone_number": "703-807-5899",
            "fax_number": "703-807-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN CRANIAL AFFILIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EASTERN CRANIAL AFFILIATES, LLC",
        "enumeration_date": "2017-06-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TERPENNING",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-807-5899"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Infinite Life",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Infinite Life",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 21, 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.