Individual provider Active NPI

Victoria Anne Kouanang

  • Nurse Practitioner
  • Springfield, NJ
National Provider Identifier
1629616941
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ01203100 Issued in NJ
Practice address
155 Morris Ave Ste 204
Springfield, NJ 07081-1224
Phone
(973) 232-2300
Fax
(973) 232-2301
NPI assigned
Dec 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN705911 PA
Nurse Practitioner 363L00000X 26NJ01203100 NJ Primary

Addresses

Primary practice location

155 Morris Ave Ste 204
Springfield, NJ 07081-1224

Mailing address

155 Morris Ave Ste 204
Springfield, NJ 07081-1224
Phone (303) 330-7391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200116002138 PA Practitioner - Nurse Practitioner 4688009814 Reassigns benefits to 1 organization
I20220801000218 NJ Practitioner - Nurse Practitioner 4688009814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01203100NJMDNurse Practitioner
RN705911PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Nov 23, 2019 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Current Accepting new patients
Practice Associates Medical Group CurrentSince Jun 15, 2022 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Nov 23, 2019 Accepting new patients

Locations

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

155 Morris Ave
Ste 204
Springfield, NJ 07081
Phone (973) 232-2300

51 N 39th St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-9189

7133 Roosevelt Blvd
Philadelphia, PA 19149
Phone (215) 333-3311

Organizations & group practices 4

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": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1629616941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 MORRIS AVE STE 204",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811224",
            "telephone_number": "303-330-7391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MORRIS AVE STE 204",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811224",
            "telephone_number": "973-232-2300",
            "fax_number": "973-232-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUANANG",
        "first_name": "VICTORIA",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-17",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "RN705911",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01203100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, NJ

Sources for this page

Verify at the official NPI Registry.