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COLLABORATIVE PAIN MANAGEMENT, PLLC
NPI 1356947295
Pain Medicine - Pain Medicine in Fairfax, VA

Active since December 07, 2020CLIA 49D2209043 · Waiver
10400 EATON PL STE 312, FAIRFAX, VA 22030(703) 261-6758(703) 995-4860 Get Directions Write a Review

NPPES record last updated: December 7, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Collaborative Pain Management, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COLLABORATIVE PAIN MANAGEMENT, PLLC (NPI 1356947295) is a healthcare organization registered as a pain medicine in Fairfax, Virginia and active in the NPI registry since December 2020. The organization holds a CLIA Waiver certificate valid through January 10, 2027 and lists Michelle Marie Jacques, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1356947295
Entity TypeOrganization
Primary Taxonomy208VP0000X
Legal Business NameCOLLABORATIVE PAIN MANAGEMENT, PLLC
Location Address10400 EATON PL STE 312Fairfax, VA 22030-2208
Mailing Address10400 Eaton Pl Ste 312Fairfax, VA 22030-2208 · (703) 261-6758 · Fax (703) 995-4860
Phone(703) 261-6758
Fax(703) 995-4860
Organization SubpartNo
Authorized OfficialMichelle Marie JacquesManaging Member · (703) 261-6758
Enumeration DateDecember 7, 2020
NPPES CertifiedDecember 3, 2020
✔ NPI 1356947295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPain Medicine · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0000X
Definition
Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient's pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies.
Also ListedClinic/Center · PainTaxonomy 261QP3300X
10400 EATON PL STE 312, Fairfax, VA 22030
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2209043

Collaborative Pain Management PLLC · Fairfax, VA
Active · expires Jan 10, 2027
CLIA Number49D2209043
Laboratory TypePractitioner Other
Certificate Effective DateJanuary 11, 2025
Certificate Expiration DateJanuary 10, 2027
Laboratory DirectorMichelle M. Jacques
Laboratory Phone(703) 261-6758
Laboratory LocationCollaborative Pain Management PLLC10400 Eaton Place Suite 312, Fairfax, VA 22030
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LANDON KEITH OWEN PT
Physical Therapist
10400 EATON PL STE 312
FAIRFAX, VA 22030
Fairfax City (703) 391-2450
MICHELLE MARIE JACQUES RN-BC,AGPCNP-BC,CMT
Nurse Practitioner
10400 EATON PL STE 312
FAIRFAX, VA 22030
Fairfax City (703) 615-8422

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Collaborative Pain Management, PLLC's NPI number?

The NPI number for Collaborative Pain Management, PLLC is 1356947295. It was assigned to this organization in the NPPES registry on December 7, 2020.

Where is Collaborative Pain Management, PLLC located?

Collaborative Pain Management, PLLC is located at 10400 Eaton Pl Ste 312, Fairfax, VA 22030. The listed phone number is (703) 261-6758.

What is Collaborative Pain Management, PLLC's specialty?

The primary specialty registered for this NPI is Pain Medicine with taxonomy code 208VP0000X.

Does Collaborative Pain Management, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2209043) is associated with this NPI, valid through January 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Collaborative Pain Management, PLLC was last updated on December 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.