NPIMap

Individual provider Active NPI

Adelaide Adjovu, NP

  • Family Nurse Practitioner
  • Lyndonville, VT
National Provider Identifier
1093227571
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
101.0131968 Issued in VT
Practice address
195 Industrial Pkwy
Lyndonville, VT 05851-4511
Phone
(802) 748-9501
NPI assigned
Oct 24, 2017
Last updated
Oct 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 101.0131968 VT Primary

Addresses

Primary practice location

195 Industrial Pkwy
Lyndonville, VT 05851-4511

Mailing address

42 Hyde St Apt 1
Burlington, VT 05401-3629
Phone (702) 283-8060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20171226000139 VT Practitioner - Nurse Practitioner 7911265897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

195 Industrial Pkwy
Lyndonville, VT 05851-4511
Phone (802) 748-9501

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
101.0131968VTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Dec 18, 2017 Accepting new patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Dec 18, 2017 Accepting new patients
Northeastern Vermont Regional Hospital Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc. Past Accepting new patients

Locations

195 Industrial Pkwy
Lyndonville, VT 05851

195 Industrial Pkwy
#1
Lyndonville, VT 05851

1315 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 748-3638

Organizations & group practices 7

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 8

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": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1093227571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 HYDE ST APT 1",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013629",
            "telephone_number": "702-283-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 INDUSTRIAL PKWY",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058514511",
            "telephone_number": "802-748-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADJOVU",
        "first_name": "ADELAIDE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-24",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101.0131968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndonville, VT

Sources for this page

Verify at the official NPI Registry.