Individual provider Active NPI

Vida Kwofie

  • Family Nurse Practitioner
  • Hanover, MD
National Provider Identifier
1972970705
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R195150 Issued in MD
Practice address
7535 Knoll Acres Rd
Hanover, MD 21076-1540
Phone
(240) 644-3995
NPI assigned
Aug 27, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R195150 MD Primary

Addresses

Primary practice location

7535 Knoll Acres Rd
Hanover, MD 21076-1540

Mailing address

7535 Knoll Acres Rd
Hanover, MD 21076-1540
Phone (240) 644-3995

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
I20151117001573 MD Practitioner - Nurse Practitioner 0840500104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Futurecare Rehabilitation Services IncGroup PAC ID 3072591999, 10 clinicians

Practice addresses (Care Compare)

8028 Ritchie Hwy
Suite 210
Pasadena, MD 21122-1075
Phone (410) 733-3292

Merit-based Incentive Payment System (MIPS)

Final score
74.39 of 100Reported as group
Quality
30.81
Improvement activities
40
Cost
73.54

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R195150MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Victory Springs, Inc CurrentSince Feb 1, 2022 Accepting new patients

Locations

19 Walker Ave
Ste 203
Pikesville, MD 21208
Phone (410) 526-1490

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1972970705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7535 KNOLL ACRES RD",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761540",
            "telephone_number": "240-644-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7535 KNOLL ACRES RD",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761540",
            "telephone_number": "240-644-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWOFIE",
        "first_name": "VIDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R195150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, MD

Sources for this page

Verify at the official NPI Registry.