NPIMap

Organization Active NPI

Victory Medical Center

  • Primary Care Clinic/Center
  • Baltimore, MD
National Provider Identifier
1740798412
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
VICTORY MEDICAL CENTER
Practice address
1101 N Point Blvd Ste 110
Baltimore, MD 21224-3417
Phone
(443) 449-3003
NPI assigned
Jan 17, 2018
Last updated
Apr 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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

Authorized official

Name
Victoria Adaramaja, DNP
Title
Nurse Practitioner
Phone
(443) 449-3003

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Health Service Clinic/Center 261QH0100X
Primary Care Clinic/Center 261QP2300X Primary
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

1101 N Point Blvd Ste 110
Baltimore, MD 21224-3417

Mailing address

1101 N Point Blvd Ste 110
Baltimore, MD 21224-3417
Phone (443) 449-3003

Other practice location 1

9729 Biggs Rd
Middle River, MD 21220-3772
Phone (401) 473-6832

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180313000959 MD Part B Supplier - Clinic/Group Practice 0446512388 Receives reassigned benefits from 2 practitioners
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory
Tax ID family
Victory Medical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1516147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524787200000",
    "number": "1740798412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N POINT BLVD STE 110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243417",
            "telephone_number": "443-449-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N POINT BLVD STE 110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243417",
            "telephone_number": "443-449-3003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9729 Biggs Rd",
            "address_purpose": "LOCATION",
            "city": "Middle River",
            "state": "MD",
            "postal_code": "212203772",
            "country_code": "US",
            "telephone_number": "401-473-6832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VICTORY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-17",
        "last_updated": "2018-04-27",
        "status": "A",
        "authorized_official_last_name": "ADARAMAJA",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "443-449-3003",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; 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.