MRS. VICTORIA OLUFUNMILOLA AGBOLA (APRN) – Family Nurse Practitioner, NPI 1225479637
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MRS. VICTORIA OLUFUNMILOLA AGBOLA (APRN)
PO BOX 3299
CARSON CITY, NV 897023299
Phone: (775) 222-0042
Fax: (775) 222-0042
Type: Mailing
828 LANE ALLEN RD STE 219
LEXINGTON, KY 40504
Phone: (177) 821-5773
Fax: (317) 780-5538
Type: Location
PO BOX 909
LOUISVILLE, KY 402010909
Phone:
Type: Mailing
2401 TERRA CROSSING BLVD STE 100
LOUISVILLE, KY 402455395
Phone: (502) 588-0746
Type: Location
828 Lane Allen Rd Ste 219
Lexington, KY 40504
Phone: (177) 821-5773
Fax: (317) 780-5538
Type: Location
2406 W BROADWAY
LOUISVILLE, KY 402111008
Phone: (502) 775-1211
Type: Location
1395 NW 167TH ST
MIAMI GARDENS, FL 331695710
Phone: (502) 775-1211
Fax: (502) 443-9391
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-10-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-10-31 (949 days ago).
Enrollment records
1
Earliest due date
2023-10-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20131008000898 | I | Nurse Practitioner | KY | 2023-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 89702)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | KY | |
| - | MD | |
| Nurse Practitioner | KY | |
| - | NV | |
| - | IN | |
| - | KY |
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