Active NPI
Victor Ifeanyi Abadom
- Chiropractor
- Baltimore, MD
National Provider Identifier
1265939722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- S03968
- Practice address
- 3914 Hickory Ave
Baltimore, MD 21211-1834 - Phone
- (443) 472-8760
- NPI assigned
- Apr 11, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | S03968 | MD | Primary |
Addresses
Primary practice location
3914 Hickory Ave
Baltimore, MD 21211-1834
Mailing address
3914 Hickory Ave
Baltimore, MD 21211-1834
Phone (410) 662-4476
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260320003426 | MD | Practitioner - Chiropractic | 8325453491 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- New York Chiropractic College, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
120 Emily Diamond Way
Covington, LA 70433-2674
17830 Old Frederick Rd
Mount Airy, MD 21771-3604
539 W Commerce St
Dallas, TX 75208-1953
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S03968 | MD | MD | Chiropractor |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523404800000",
"number": "1265939722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3914 HICKORY AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212111834",
"telephone_number": "410-662-4476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3914 HICKORY AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212111834",
"telephone_number": "443-472-8760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABADOM",
"first_name": "VICTOR",
"middle_name": "IFEANYI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-11",
"last_updated": "2018-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MD",
"license": "S03968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.