Ma Victoria Aquino Khera, AGPCNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

243278 Issued in GA

Practice address

2467 Golden Camp Rd
Augusta, GA 30906-5515

Phone

(706) 790-4440

NPI assigned

Dec 28, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Ma Victoria Villanueva Aquino Other name

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1508301649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 BURGAMY PASS",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308135855",
            "telephone_number": "714-624-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2467 GOLDEN CAMP RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065515",
            "telephone_number": "706-790-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHERA",
        "first_name": "MA VICTORIA",
        "middle_name": "AQUINO",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-28",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "243278",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "243278",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "243278",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MA VICTORIA",
            "last_name": "AQUINO",
            "middle_name": "VILLANUEVA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Saad Uzair Khan, PHARM.D.
• Sohail Khan, M.D.
• Hussein Kharroubi, MD
• Mostafa Kamel Khater
• Krishan Khera, M.D.
• Rakhi N Kheraj, MD
• Kailash Khiani, M.D.
• Vijanti Khiani, M.D.
• Samir N Khleif, M.D.
• David Yong Kho, PHARM.D.

• Adult Health Nurse Practitioner in Augusta, GA
• Providers in Augusta, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.