NPIMap

Organization Active NPI

Vastcare Medical Clinic

  • Family Nurse Practitioner
  • Lanham, MD
National Provider Identifier
1730647660
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
VASTCARE MEDICAL CLINIC
Practice address
9470 Annapolis Rd Ste 115
Lanham, MD 20706-3025
Phone
(301) 708-0100
Fax
(301) 708-0101
NPI assigned
Mar 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Dr. Stella O. Akpuaka, NURSE PRACTITIONERNPI 1972977353
Title
Provider
Phone
(301) 708-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X
Primary Care Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

9470 Annapolis Rd Ste 115
Lanham, MD 20706-3025

Mailing address

9470 Annapolis Rd Ste 115
Lanham, MD 20706-3025
Phone (301) 708-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200717000065 DC Part B Supplier - Clinic/Group Practice 2860816329 Receives reassigned benefits from 1 practitioner
Practice locations: Lanham, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1730647660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9470 ANNAPOLIS RD STE 115",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063025",
            "telephone_number": "301-708-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9470 ANNAPOLIS RD STE 115",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063025",
            "telephone_number": "301-708-0100",
            "fax_number": "301-708-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASTCARE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "AKPUAKA",
        "authorized_official_first_name": "STELLA",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "301-708-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.