Individual provider Active NPI

Vivian Ndem

  • General Practice Registered Nurse
  • Bowie, MD
National Provider Identifier
1457611790
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
R197214 Issued in MD
Practice address
12312 Quintette LN
Bowie, MD 20720-4363
Phone
(227) 218-5466
NPI assigned
May 21, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X
General Practice Registered Nurse 163WG0000X R197214 MD Primary

Addresses

Primary practice location

12312 Quintette LN
Bowie, MD 20720-4363

Mailing address

1818 New York Ave NE
228
Washington, DC 20002-1848
Phone (202) 832-8340

Other practice location 1

1818 New York Ave NE
228
Washington, DC 20002-1848
Phone (202) 832-8340

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

LicenseStateTypeSpecialty
R197214MDMDGeneral Practice Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1457611790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 NEW YORK AVE NE",
            "address_2": "228",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200021848",
            "telephone_number": "202-832-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12312 QUINTETTE LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204363",
            "telephone_number": "227-218-5466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1818 New York Ave NE",
            "address_2": "228",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200021848",
            "country_code": "US",
            "telephone_number": "202-832-8340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NDEM",
        "first_name": "VIVIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MD",
            "license": "R197214",
            "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 Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.