Dr Vivian Adaeze Imo, DNP, CRNP-PMH in Glen Burnie, MD

Dr Vivian Adaeze Imo, DNP, CRNP-PMH is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Glen Burnie, Maryland. She graduated from nursing school in 2020 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Md Matt Llc and her current practice location is 1412 Crain Hwy N Ste 6b, Glen Burnie, Maryland. You can reach out to her office (for appointments etc.) via phone at (301) 377-6669.

Dr Vivian Adaeze Imo is licensed to practice in Maryland (license number R224518) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1528651924.

Contact Information

	Dr Vivian Adaeze Imo, DNP, CRNP-PMH
	1412 Crain Hwy N Ste 6b, Glen Burnie, MD 21061-9306
	(301) 377-6669
	(301) 477-8931

Map and Direction

Provider's Profile

Full Name	Dr Vivian Adaeze Imo
Gender	Female
Speciality	Nurse Practitioner
Experience	6 Years
Location	1412 Crain Hwy N Ste 6b, Glen Burnie, Maryland
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Vivian Adaeze Imo graduated from nursing school in 2020

NPI Data:

NPI Number: 1528651924
Provider Enumeration Date: 02/17/2021
Last Update Date: 01/31/2026

Medicare PECOS Information:

PECOS PAC ID: 3072965813
Enrollment ID: I20240117004217

Medical Identifiers

Medical identifiers for Dr Vivian Adaeze Imo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1528651924	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	R224518 (Maryland)	Primary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	2020130751 (Maryland)	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Md Matt Llc	6800297524	9

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Vivian Adaeze Imo allows following entities to bill medicare on her behalf.

Entity Name	Md Matt Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669941175 PECOS PAC ID: 6800297524 Enrollment ID: O20210701000406

Entity Name	University Psychological Center, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1841647617 PECOS PAC ID: 4789674094 Enrollment ID: O20230710002271

Entity Name	Reflections Behavioral Health
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1598348096 PECOS PAC ID: 3274986096 Enrollment ID: O20240129002356

Entity Name	Vivian Imo Psychiatry Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013775014 PECOS PAC ID: 7012357049 Enrollment ID: O20240424002697

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Vivian Adaeze Imo is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Vivian Adaeze Imo, DNP, CRNP-PMH 1412 Crain Hwy N Ste 6b, Glen Burnie, MD 21061-9306 Ph: (301) 337-6669	Dr Vivian Adaeze Imo, DNP, CRNP-PMH 1412 Crain Hwy N Ste 6b, Glen Burnie, MD 21061-9306 Ph: (301) 377-6669

Reviews and Comments

Nurse Practitioner Nurses in Glen Burnie, MD

Ms. Docia Owusu, CRNP-PMH Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7575 E Howard Rd, Glen Burnie, MD 21060 Phone: 410-768-8200
Mrs. Theresa Eileen Deveaux, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 301 Hospital Dr, Glen Burnie, MD 21061 Phone: 410-553-8300 Fax: 410-553-8349
Ms. Linda Jean Swallow, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 305 Hospital Dr, 1st Floor, Glen Burnie, MD 21061 Phone: 410-552-8154 Fax: 410-553-8134
Mary Bourbon, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1600 S. Cain Highway, Suite 401, Glen Burnie, MD 21061 Phone: 410-768-5050
Christine Marie Habersaat, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1405 Madison Park Dr Ste 1, Glen Burnie, MD 21061 Phone: 410-582-9434
Opemipo Doyin Ogeyingbo, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 464 Norvelle Ct, Glen Burnie, MD 21061 Phone: 301-592-7286
Cierra N Vaughters, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 325 Hospital Dr Ste 106, Glen Burnie, MD 21061 Phone: 443-430-2998

Dr Vivian Adaeze Imo, DNP, CRNP-PMH - Medicare Nurse Practitioner in Glen Burnie, MD