NPIMap

Organization Active NPI

Victory Springs, Inc

  • Internal Medicine Physician
  • Reisterstown, MD
National Provider Identifier
1770530982
Registry record updated Sep 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0059107 Issued in MD
Legal business name
VICTORY SPRINGS, INC
Practice address
210 Business Center Dr
Reisterstown, MD 21136-1230
Phone
(410) 526-1490
Fax
(410) 526-9363
NPI assigned
May 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2009

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

Authorized official

Name
Dr. Kalu A Uma, M.D.
Title
President
Phone
(410) 526-1490

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X D0059107 MD Primary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X D0059107 MD

Addresses

Primary practice location

210 Business Center Dr
Reisterstown, MD 21136-1230

Mailing address

210 Business Center Dr
Reisterstown, MD 21136-1230
Phone (410) 526-1490

Other identifiers 5

IdentifierTypeStateIssuer
211400300MedicaidMD
850LOtherMDMEDICARE
G988OtherMDBC/BS FEDERAL PROGRAM
LRV2VIOtherMDBLUE CROSS
1234OtherMDRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060317000279 MD Part B Supplier - Clinic/Group Practice 2668489543 Receives reassigned benefits from 6 practitioners
Practice locations: Pikesville, MD

National Provider Directory

National Provider Directory

Locations

5412 Old Court Rd
Randallstown, MD 21133
Phone (410) 922-3200

210 Business Center Dr
Reisterstown, MD 21136
Phone (410) 526-1490

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252627200000",
    "number": "1770530982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 BUSINESS CENTER DR",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361230",
            "telephone_number": "410-526-1490",
            "fax_number": "410-526-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BUSINESS CENTER DR",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361230",
            "telephone_number": "410-526-1490",
            "fax_number": "410-526-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY SPRINGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2009-09-11",
        "status": "A",
        "authorized_official_last_name": "UMA",
        "authorized_official_first_name": "KALU",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-526-1490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0059107",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D0059107",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211400300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "850L",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS FEDERAL PROGRAM",
            "identifier": "G988",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "LRV2VI",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "1234",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reisterstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; 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.