Organization Active NPI

Advanced Rheumatology & Wellness Center LLC

  • Rheumatology Physician
  • Leesburg, VA
National Provider Identifier
1487468799
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
ADVANCED RHEUMATOLOGY & WELLNESS CENTER LLC
Practice address
19500 Sandridge Way
Leesburg, VA 20176-3688
Phone
(703) 723-3398
Fax
(703) 723-9128
NPI assigned
Feb 5, 2025
Last updated
Feb 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Authorized official

Name
Jennifer Odutola, MDNPI 1750397725
Title
Authorized Official
Phone
(703) 723-3398

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X NU Primary

Addresses

Primary practice location

19500 Sandridge Way
Leesburg, VA 20176-3688

Mailing address

19500 Sandridge Way
Leesburg, VA 20176-3688

Other practice location 1

205 Hirst Rd Ste 202
Purcellville, VA 20132-6600
Phone (703) 723-3398

National Provider Directory

National Provider Directory

Locations

19500 Sandridge Way
Leesburg, VA 20176
Phone (703) 723-3398

205 Hirst Rd
Ste 202
Purcellville, VA 20132
Phone (540) 338-1215

Practitioners & affiliated clinicians

Practitioners 2

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": "1738713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1487468799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19500 SANDRIDGE WAY",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SANDRIDGE WAY",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763688",
            "telephone_number": "703-723-3398",
            "fax_number": "703-723-9128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Hirst Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Purcellville",
            "state": "VA",
            "postal_code": "201326600",
            "country_code": "US",
            "telephone_number": "703-723-3398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED RHEUMATOLOGY & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "ODUTOLA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "703-723-3398",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.