Active NPI
Vicky Adam Jennifer, HOME HEALTH AIDE
- Home Health Registered Nurse
- Bowie, MD
National Provider Identifier
1164763371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- License
- 7902
- Practice address
- 2502 Sant Joseph Dr
Bowie, MD 20721 - Phone
- (301) 256-4505
- NPI assigned
- Mar 13, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 7902 | MD | Primary |
Addresses
Primary practice location
2502 Sant Joseph Dr
Bowie, MD 20721
Mailing address
2502 Saint Josephs Dr
Bowie, MD 20721-2995
Phone (301) 256-4505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7902 | MD | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363132800000",
"number": "1164763371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2502 SAINT JOSEPHS DR",
"city": "BOWIE",
"state": "MD",
"postal_code": "207212995",
"telephone_number": "301-256-4505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2502 SANT JOSEPH DR",
"city": "BOWIE",
"state": "MD",
"postal_code": "20721",
"telephone_number": "301-256-4505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNIFER",
"first_name": "VICKY",
"middle_name": "ADAM",
"name_prefix": "Mrs.",
"credential": "HOME HEALTH AIDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-13",
"last_updated": "2013-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "MD",
"license": "7902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.