Edgar Tating Victoria, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

7957 Issued in AL

Practice address

1411 Piedmont Cutoff
Gadsden, AL 35903

Phone

(256) 492-0131

NPI assigned

Aug 19, 2006

Last updated

Mar 25, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Quality of Life Health Services Inc

  dba Quality of Life Health Complex

  • Community Health Clinic/Center
  • Gadsden, AL
  • NPI 1447200977
  Medicare reassignment NPD
• Quality of Life Health Services, Inc

  dba Calhoun Quality Health Care

  • Federally Qualified Health Center (FQHC)
  • Anniston, AL
  • NPI 1013339209
  NPD
• Quality of Life Health Services, Inc

  dba Cleburne Quality Health Care

  • Federally Qualified Health Center (FQHC)
  • Heflin, AL
  • NPI 1467620989
  NPD
• Quality of Life Health Services, Inc

  dba Anniston Quality Health Care

  • Community Health Clinic/Center
  • Anniston, AL
  • NPI 1568412666
  NPD
• Jacksonville Medical Professional Services LLC

  • Certified Registered Nurse Anesthetist
  • Jacksonville, AL
  • NPI 1073731774

  Surgery

  NPD (past)
• QHG of Jacksonville Inc

  dba Jacksonville Medical Center

  • Anesthesiology Physician
  • Jacksonville, AL
  • NPI 1457458820
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1023122421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 97",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "35902",
            "telephone_number": "256-492-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 PIEDMONT CUTOFF",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "35903",
            "telephone_number": "256-492-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORIA",
        "first_name": "EDGAR",
        "middle_name": "TATING",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "AL",
            "license": "00007957",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "7957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009923940",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000046490",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "51094372",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143836 (CLEBURNE)",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143752 (WADLEY)",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143995 (COMPLEX)",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51046490",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS TAXPER IDENTIFICATION",
            "identifier": "630736845",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100906",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143754 (ANNISTON)",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Vondrea Vawters, PHARMD
• Jordan Veazey, MS, BCBA
• Cyrus Shawn Vepa, MD
• Holly Yates Vezertzis, CRNP
• April Amanda Vice, PHARM.D.
• Village Counseling and Consulting, LLC
• Lisa Vinyard, P.T.
• Ronald L Vinyard, R.PH.
• Shubadha Virenjan, DDS
• Voli Rehab LLC

• Surgery Physician in Gadsden, AL
• Providers in Gadsden, AL by specialty
• Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.