EASTERN CRANIAL AFFILIATES, LLC (NPI# 1437689932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437689932 |
| Entity Type | Organization |
| Organization Name | EASTERN CRANIAL AFFILIATES, LLC |
| Other Organization Name | INFINITE LIFE |
| Practice Address |
10523 Main St Fairfax VA 22030-3310 |
| Practice Telephone | (703) 807-5899 |
| Practice Fax Number | 7038071183 |
| Mailing Telephone | 7038075899 |
| Mailing Fax Number | 7038071183 |
| Enumeration Date | 2017-06-16 |
| Last Update Date | 2017-06-16 |
| Authorized Official Name | JOSEPH TERPENNING (OWNER) |
| Authorized Official Telephone | 7038075899 |
| Is Organization Subpart | Y |
| Parent Organization Name | EASTERN CRANIAL AFFILIATES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Infinite Life | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508954157 | Eastern Cranial Affiliates, LLC | Durable Medical Equipment & Medical Supplies | 10523 Main St, Fairfax, VA 22030 | 2006-10-10 |
| 1437525201 | Eastern Cranial Affiliates, LLC | Prosthetic/Orthotic Supplier | 44055 Riverside Pkwy, Suite 106a, Leesburg, VA 20176-5179 | 2015-08-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | EASTERN CRANIAL AFFILIATES, LLC | 3900 N. Fairfax Drive, Suite 100, Arlington, Va 22203 |
| Street Address |
10523 MAIN ST |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-3310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508954157 | Eastern Cranial Affiliates, LLC | Durable Medical Equipment & Medical Supplies | 10523 Main St, Fairfax, VA 22030 | 2006-10-10 |
| 1235596420 | Lacey Rebecca Dungan | Specialist/Technologist | 10523 Main St, Fairfax, VA 22030-3310 | 2016-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932753811 | Resurgent Sports Rehab LLC | Clinic/Center | 8500 Executive Park Ave Ste 100, Fairfax, VA 22031-2228 | 2019-07-29 |
| 1114468188 | Occupational Health Centers of The Southwest, P.a., P.C. | Clinic/Center | 8613 Lee Hwy, Suite 110, Fairfax, VA 22031-2171 | 2017-03-10 |
| 1235558347 | Dynamic Rehab Inc | Clinic/Center | 8316 Arlington Blvd Ste 520, Fairfax, VA 22031-5216 | 2014-04-16 |
| 1255771515 | Hamid Espandyari | Clinic/Center | 8316 Arlington Blvd #520, Fairfax, VA 22031 | 2013-07-01 |
| 1780933028 | Ace Physical Therapy & Sports Medicine Institute, LLC | Clinic/Center | 12011 Lee Jackson Memorial Hwy Ste 101, Fairfax, VA 22033-3310 | 2012-08-31 |
| 1649305277 | Applied Physical Therapy, Inc | Clinic/Center | 10373a Democracy Ln, Fairfax, VA 22030-2505 | 2007-02-23 |
| 1104461441 | Primus Physical Therapy Fairfax | Clinic/Center | 3025 Hamaker Ct Ste 103, Fairfax, VA 22031-2221 | 2019-11-11 |
| 1982097465 | Proactive Physical Therapy and Wellness LLC | Clinic/Center | 3903 Fair Ridge Dr, 211, Fairfax, VA 22033-2943 | 2015-03-09 |
| 1609211036 | Fitness and Rehabilitation, Inc. | Clinic/Center | 10400 Eaton Pl, Suite 312, Fairfax, VA 22030-2208 | 2013-04-29 |
| 1336366079 | The Temple Foundation Inc | Clinic/Center | 9229 Arlington Blvd, Fairfax, VA 22031-2504 | 2007-04-20 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.