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DR. VIVIAN ADAEZE IMO DNP, CRNP-PMH
NPI 1528651924
Nurse Practitioner - Psychiatric/Mental Health in Glen Burnie, MD

Active since February 17, 2021PECOS Enrolled
1412 CRAIN HWY N STE 6B, GLEN BURNIE, MD 21061(301) 377-6669(301) 477-8931 Get Directions Write a Review

NPPES record last updated: January 31, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jan 31, 2026, Aug 17, 2022, Mar 22, 2021 and 2 more (5 updates tracked since 2021).

About Dr. Vivian Adaeze Imo Dnp, Crnp-pmh NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. VIVIAN ADAEZE IMO DNP, CRNP-PMH (NPI 1528651924) is an individual psychiatric/mental health provider in Glen Burnie, Maryland, licensed in Maryland (R224518) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1528651924
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameDR. VIVIAN ADAEZE IMOCredential: DNP, CRNP-PMH
Location Address1412 CRAIN HWY N STE 6BGlen Burnie, MD 21061-9306
Mailing Address1412 Crain Hwy N Ste 6bGlen Burnie, MD 21061-9306 · (301) 337-6669 · Fax (301) 477-8931
Phone(301) 377-6669
Fax(301) 477-8931
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateFebruary 17, 2021
Last NPPES UpdateJanuary 31, 20265 updates tracked since enumeration
NPPES CertifiedJanuary 31, 2026
✔ NPI 1528651924 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in MD · R224518✔ Licensed in MD · 2020130751
1412 CRAIN HWY N STE 6B, Glen Burnie, MD 21061
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Vivian Adaeze Imo Dnp, Crnp-pmh is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3072965813
PECOS Enrollment IDI20240117004217
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Vivian Imo reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Psychological Center, Inc
9.0 mi
Mental Health (Including Community Mental Health Center)
21 W 25TH ST
Baltimore, MD 21218
  • Reassigned Medicare billing, Maryland enrollment
  • 14 clinicians in this Medicare group
NPI 1841647617 (410) 366-1717
Reflections Behavioral Health
16 mi
Mental Health (Including Community Mental Health Center)
8840 BELAIR RD
Baltimore, MD 21236
  • Reassigned Medicare billing, Maryland enrollment
  • 7 clinicians in this Medicare group
NPI 1598348096 (667) 262-9100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21061 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.08 typical visit price
range $60.73 – $183.44
Typical copayment $23.52 (range $15.18 – $45.86)
Most-billed visit code 99203
Established Patient
$106.59 typical visit price
range $19.60 – $149.17
Typical copayment $26.64 (range $4.90 – $37.29)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VIVIAN IMO PSYCHIATRY, LLC
Nurse Practitioner (Psychiatric/Mental Health)
1412 CRAIN HWY N STE 6B
GLEN BURNIE, MD 21061
Anne Arundel County (301) 337-6669
LIFE SUPPORT CLINICAL COUNSELING SERVICE LLC/PRP
Community/Behavioral Health
1412 CRAIN HWY N STE 6B
GLEN BURNIE, MD 21061
Anne Arundel County (410) 980-3163
RECOVERYRX LLC
Nurse Practitioner (Psychiatric/Mental Health)
1412 CRAIN HWY N STE 6B
GLEN BURNIE, MD 21061
Anne Arundel County (410) 449-7007

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vivian Imo's NPI number?

The NPI number for Vivian Imo is 1528651924. It was assigned to this individual provider in the NPPES registry on February 17, 2021.

Where is Vivian Imo located?

Vivian Imo practices at 1412 Crain Hwy N Ste 6B, Glen Burnie, MD 21061. The listed phone number is (301) 377-6669.

What is Vivian Imo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Vivian Imo enrolled in Medicare?

Yes. Vivian Imo is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Vivian Imo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Vivian Imo reassigns Medicare benefits to 2 organizations: University Psychological Center, Inc (Baltimore, MD) and Reflections Behavioral Health (Baltimore, MD). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Vivian Imo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Vivian Imo was last updated on January 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.