Individual provider Active NPI

Vivian Craft

  • Psychiatric/Mental Health Nurse Practitioner
  • Edgewater, MD
National Provider Identifier
1780443887
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R160004 Issued in MD
Practice address
2600 Solomons Island Rd
Edgewater, MD 21037-1102
Phone
(443) 433-5900
NPI assigned
Mar 19, 2024
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R160004 MD Primary

Addresses

Primary practice location

2600 Solomons Island Rd
Edgewater, MD 21037-1102

Mailing address

2002 Medical Pkwy Ste 460
Annapolis, MD 21401-3263
Phone (443) 590-3224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240808002120 MD Practitioner - Nurse Practitioner 0446794390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians
Arundel Lodge, Inc.Group PAC ID 8123197050, 16 clinicians

Practice addresses (Care Compare)

133 Defense Hwy
Annapolis, MD 21401-7015

2002 Medical Pkwy
Suite 460
Annapolis, MD 21401-3263
Phone (443) 433-5900

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arundel Lodge, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Arundel Lodge, Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

2002 Medical Pkwy
Ste 460
Annapolis, MD 21401
Phone (410) 266-2725

2600 Solomons Island Rd
Edgewater, MD 21037
Phone (443) 433-5900

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1780443887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY STE 460",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013263",
            "telephone_number": "443-590-3224",
            "fax_number": "410-841-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SOLOMONS ISLAND RD",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210371102",
            "telephone_number": "443-433-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAFT",
        "first_name": "VIVIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R160004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, MD

Sources for this page

Verify at the official NPI Registry.