Individual provider Active NPI

Emmaculate Ndifor, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodbridge, VA
National Provider Identifier
1457802498
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024174051 Issued in VA
Practice address
14497 Potomac Mills Rd # 1133
Woodbridge, VA 22192-6807
Phone
(130) 133-5845
NPI assigned
Oct 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R182600 MD
Family Nurse Practitioner 363LF0000X 0024174051 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024174051 VA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R182600 MD

Addresses

Primary practice location

14497 Potomac Mills Rd # 1133
Woodbridge, VA 22192-6807

Mailing address

12449 Pfitzner CT
Woodbridge, VA 22192-5595
Phone (301) 335-8453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190220003234 VA Practitioner - Nurse Practitioner 0042558892 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R182600MDMDFamily Nurse Practitioner

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": "1476403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1457802498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12449 PFITZNER CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925595",
            "telephone_number": "301-335-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14497 POTOMAC MILLS RD # 1133",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221926807",
            "telephone_number": "130-133-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDIFOR",
        "first_name": "EMMACULATE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-14",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R182600",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174051",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024174051",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R182600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.