Organization Active NPI

Abundance Primary Care LLC

  • Family Nurse Practitioner
  • Fredericksburg, VA
National Provider Identifier
1780558270
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ABUNDANCE PRIMARY CARE LLC
Practice address
4500 Plank Rd Ste 1024B
Fredericksburg, VA 22407-0120
Phone
(540) 527-5113
Fax
(540) 767-6333
NPI assigned
Sep 30, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Authorized official

Name
Hermine Henry, FNP-CNPI 1184212235
Title
Medical Director
Phone
(321) 276-7402

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

4500 Plank Rd Ste 1024B
Fredericksburg, VA 22407-0120

Mailing address

PO Box 41021
Fredericksburg, VA 22404-1021
Phone (540) 527-5113

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251202001586 VA Part B Supplier - Clinic/Group Practice 6002309721 Receives reassigned benefits from 2 practitioners
Practice locations: Fredericksburg, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2337853Abundance Primary Care LLC4500 Plank Rd, Suite 1024B, Fredericksburg, VA 22407Certificate of waiverJan 29, 2028

National Provider Directory

National Provider Directory

Locations

4500 Plank Rd
Ste 1024B
Fredericksburg, VA 22407
Phone (321) 276-7402

Practitioners & affiliated clinicians

Practitioners 1

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": "1759190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1780558270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41021",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224041021",
            "telephone_number": "540-527-5113",
            "fax_number": "540-767-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PLANK RD STE 1024B",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224070120",
            "telephone_number": "540-527-5113",
            "fax_number": "540-767-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANCE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-30",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "HERMINE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "321-276-7402",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.