Victoria Susan Wei Fan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT017209 Issued in GA

Practice address

3280 Peachtree Rd NE # 110B
Atlanta, GA 30305-2430

Phone

(770) 335-9796

NPI assigned

Jul 11, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Mercer University School of Medicine, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Westside Physical Therapy, LLCGroup PAC ID 6507185212, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Westside Physical Therapy, LLC

  dba Movement Sports Physical Therapy, LLC

  • Orthopedic Physical Therapist
  • Atlanta, GA
  • NPI 1669862769
  Medicare reassignment Care Compare group NPD
• Motion Stability, LLC

  • Physical Therapy Clinic/Center
  • Atlanta, GA
  • NPI 1174760896

  Physical Therapist

  NPD

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1003653528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 PEACHTREE RD NE # 110B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052430",
            "telephone_number": "770-335-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 PEACHTREE RD NE # 110B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052430",
            "telephone_number": "770-335-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "VICTORIA",
        "middle_name": "SUSAN WEI",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Skin Specialists LLC
• Family Solutions of Georgia LLC (Clarinda Squires)
• Family Support Services of Georgia
• Famo Healthcare Services LLC (Avant Care)
• Lucie Kaiyi Fan
• Robert Chen Fang, M.D.
• Zachary Brook Fang
• Jason Fangusaro, MD
• Negar Fani, PHD
• Hana Fankhouser

• Physical Therapist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.