NPIMap

Individual provider Active NPI

Jennifer Odutola, MD

  • Rheumatology Physician
  • Lansdowne, VA
National Provider Identifier
1750397725
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
0101234395 Issued in VA
Practice address
19500 Sandridge Way Ste 170
Lansdowne, VA 20176-3692
Phone
(703) 723-3398
Fax
(703) 723-7464
NPI assigned
Jul 31, 2006
Last updated
Dec 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 0101234395 VA Primary

Addresses

Primary practice location

19500 Sandridge Way Ste 170
Lansdowne, VA 20176-3692

Mailing address

224D Cornwall St NW Ste 403
Leesburg, VA 20176-2704
Phone (703) 443-6717

Other practice location 1

24430 Stone Springs Blvd Unit 100
Dulles, VA 20166-2269
Phone (037) 233-3987

Other practice location 2

205 East Hirst Road Suite 304
Purcellville, VA 20132-6602
Phone (703) 723-3398

Other identifiers 1

IdentifierTypeStateIssuer
1750397725MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060112000538 VA Practitioner - Rheumatology 0547283897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loudoun Rheumatology Center, PCGroup PAC ID 9931122280, 2 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

19500 Sandridge Way
Suite 170
Lansdowne, VA 20176-3692
Phone (703) 723-3398

9642 Burke Lake Rd
Burke, VA 22015-3052
Phone (703) 543-7920

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.46 of 100Reported as individual
Quality
55.95
Improvement activities
40
Cost
76.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Rheumatology Center, PC Rheumatology Current Accepting new patients
Loudoun Rheumatology Center, PC Rheumatology CurrentSince Nov 1, 2005 Accepting new patients
Advanced Rheumatology & Wellness Center LLC Rheumatology PastSince Feb 9, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

19415 Deerfield Ave
Ste 106
Leesburg, VA 20176
Phone (703) 723-5398

19465 Deerfield Ave
Ste 309
Leesburg, VA 20176
Phone (703) 723-3398

19500 Sandridge Way
Ste 170
Leesburg, VA 20176
Phone (703) 723-3398

205 Hirst Rd
Ste 304
Purcellville, VA 20132
Phone (703) 723-3398

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1800/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jennifer.odutola.1@1800.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1750397725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224D CORNWALL ST NW STE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-443-6717",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SANDRIDGE WAY STE 170",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201763692",
            "telephone_number": "703-723-3398",
            "fax_number": "703-723-7464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24430 Stone Springs Blvd Unit 100",
            "address_purpose": "LOCATION",
            "city": "Dulles",
            "state": "VA",
            "postal_code": "201662269",
            "country_code": "US",
            "telephone_number": "037-233-3987",
            "fax_number": "703-723-7464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 East Hirst Road Suite 304",
            "address_purpose": "LOCATION",
            "city": "Purcellville",
            "state": "VA",
            "postal_code": "201326602",
            "country_code": "US",
            "telephone_number": "703-723-3398",
            "fax_number": "703-723-7464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODUTOLA",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "VA",
            "license": "0101234395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750397725",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdowne, VA

Sources for this page

Verify at the official NPI Registry.