Individual provider Active NPI

Abidemi Victoria Ibidapo

  • Acute Care Nurse Practitioner
  • Mount Holly, NJ
National Provider Identifier
1538059167
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ15350900 Issued in NJ
Practice address
175 Madison Ave FL 1
Mount Holly, NJ 08060-2038
Phone
(609) 914-6000
Fax
(609) 914-6182
NPI assigned
Jul 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26NJ15350900 NJ Primary

Addresses

Primary practice location

175 Madison Ave FL 1
Mount Holly, NJ 08060-2038

Mailing address

178 E Country Club Dr
Westampton, NJ 08060-4732
Phone (609) 532-0614

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aibidapo26320@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20251118000927 NJ Practitioner - Nurse Practitioner 3678064615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

175 Madison Ave
Mount Holly, NJ 08060-2038

218 Sunset Rd
FL 5
Willingboro, NJ 08046-1110
Phone (609) 444-0359

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ15350900NJMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Oct 12, 2025 Accepting new patients
Virtua Medical Group, PA CurrentSince Oct 12, 2025 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

175 Madison Ave
Fl 1
Mount Holly, NJ 08060
Phone (609) 914-6000

Interoperability endpoints

  • Direct secure messaging: aibidapo26320@directvirtua.org

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1538059167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 E COUNTRY CLUB DR",
            "city": "WESTAMPTON",
            "state": "NJ",
            "postal_code": "080604732",
            "telephone_number": "609-532-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MADISON AVE FL 1",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602038",
            "telephone_number": "609-914-6000",
            "fax_number": "609-914-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBIDAPO",
        "first_name": "ABIDEMI",
        "middle_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ15350900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aibidapo26320@directvirtua.org",
            "affiliation": "N",
            "address_1": "175 Madison Ave Fl 1",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080602038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Holly, NJ

Sources for this page

Verify at the official NPI Registry.